Under physiological conditions, the tricuspid valve regulates the blood flow from the right atrium to the right ventricle. It consists of three leaflets, the anterior, the posterior and the septal leaflet which are connected to a fibrous ring (annulus) and anchored by chordae tendineae at three papillar muscles of the right ventricular wall. The surgical therapy of tricuspid valve disease – isolated or in conjunction with mitral valve surgery – includes the opening of the chest-wall in an open heart surgery, involving a heart-lung machine.
New techniques which allow for the treatment of heart valve diseases without open heart surgery are already being clinically applied or in the state of advanced clinical trials. These methods focus on the treatment of the heart valves of the left heart. Around 20 % of patients with an indication for mitral valve surgery need a correction of a secondary tricuspid valve vitium. Internationally, the isolated tricuspid valve insufficiency represents 1 % of all heart valve diseases. There is a considerable number of patients who develop a secondary symptomatic tricuspid valve insufficiency months to years after mitral valve replacement. For this group of patients (mostly elderly patients), an open heart surgery is associated with high risks. The availability of an interventional treatment of tricuspid valve insufficiency may significantly increase the clinical outcome of this group of patients.
In cooperation with the Department of Cardiothoracic-Surgery at the university hospital Aachen (UKA), a new approach for a therapy of tricuspid valve insufficiency with a new interventionally positionable, valved structure is being developed.