IJN first in Asia to use TricValve® procedure on tricuspid regurgitation

Bioprosthesis is a procedure which uses a dry stent-valve on a preloaded delivery system 

by AZALEA AZUAR / pic by TMR

THE National Heart Institute (IJN) is the first hospital in Asia to perform a bioprosthesis for patients suffering from tricuspid regurgitation or leaky heart valves. 

IJN CEO and senior consultant cardiologist Datuk Dr Aizai Azan Abdul Rahim has expressed his gratitude to the team for seeking out newer and more innovative methods of treatment. 

“It’s no secret that IJN’s success has been built on the willingness of our staff to keep learning, exploring for new innovative treatments that can enhance our patients’ quality of life and pushing the boundaries to be able to treat more patients who are deemed unsuitable for surgeries,” he said. 

The TricValve® Transcatheter Bicaval Valves system (bioprosthesis) is a procedure that uses a dry stent-valve on a preloaded delivery system and was carried out by the Heart Failure and Heart Transplant Team and Cardiology Department on May 6.

It is meant for patients who have severe tricuspid valve regurgitation who are unable to control their symptoms through other treatments and are deemed too high-risk for surgery.

According to IJN head of cardiology department and senior consultant cardiologist Dr Shaiful Azmi Yahaya, the team first conducted the procedure on a 67-year-old lady who had long-standing hypertension and also atrial fibrillation, which is an irregular heartbeat. 

“She’s actually doing very well, she’s three months post-procedure. When we perform this procedure, we look at their quality of life,” he explained. 

The TricValve® procedure is not for everyone as patients need to be assessed first. Prior to that, the patients are required to undergo intensive investigations such as CT scan and a coronary angiogram.

“I think there are three or four sizes that are suitable for this patient, and depending on the size of the superior vena cava and the inferior vena cava,” Dr Shaiful explained. 

He hopes that more insurance companies would take this procedure into account as it may cost up to RM100,000 and more. 

Since the TricValve® is a new procedure, the team had to be wary of the complications of the patients after this treatment.

The procedure is also not an outpatient treatment yet.

“If the patient is not well informed, you know, they may miss certain signs and symptoms of complications happening, because usually, they’re elderly, they are on new drugs, they might have problems with the new drug. So, we tend to keep them a little bit longer.” 

IJN clinical director, heart failure and heart transplant, consultant cardiologist Datuk Dr Azmee Mohd Ghazi explained that a common surgical option for tricuspid valve regurgitation is annuloplasty, a procedure that tightens the ring around the valve in the heart. 

“Unfortunately, in patients with severely dilated tricuspid annulus or with a prior pacemaker or other underlying conditions, they will not be suitable for such a procedure. 

“For such cases, it is important that we are able to offer a new innovative treatment like TricValve® to help more patients alleviate their symptoms and improve their quality of life,” he said. 

The dual-valve system is developed for a minimally invasive procedure and it offers a speedier recovery period. 

This increases the doctor’s learning curve and the procedure can be performed effectively while ensuring the patient’s safety.