Dr. Matthew Summers describes the minimally invasive treatment for severe tricuspid regurgitation for high-risk patients being performed at Sentara.
My name is Matt Summers. I'm the program director of Structural Heart at Centa Heart Hospital. Um I'm an interventional cardiologist and so I do minimally invasive cardiac operations, uh particularly on heart valves, um but on other structural heart problems. Um one of the exciting new uh breakthroughs in our field is transcatheter, tricuspid valve therapies. Um And so I'm excited to, to uh announce that we have capabilities for those therapies. Uh Here at Centa, we were active participants in both of the large clinical trials over the past two years and had tremendous success for our patients in both the Tricuspid valve replacement research area, as well as uh tricuspid edge to edge repair, which is a type of sealing device that eliminates leak. So, from a patient perspective, the tricuspid valve is, is a valve. We have not had any therapies for surgical or catheter based. Uh for decades, we've been uh dependent on diuretics to minimize symptoms. But with disease progression, there's an incredible mor morbidity and mortality associated with a leaky tricuspid valve. That's the valve that separates the heart's uh right sided pumping chamber which gets blood returning from the body. Uh that needs to get oxygen. The valve separates uh that system from the lungs. So when it's leaky, a lot of blood trying to return to the lungs to get oxygen is refluxed back into the body. It leads to significant lower extremity, edema, swelling and congestion in the liver and kidneys, uh progressive renal failure and then ultimately liver failure and, and people pass away from this um, at high rates because there aren't therapies for it. Traditionally, we've, we've attempted to do open heart surgery for these, but it's, it's very poorly tolerated to go on to cardiopulmonary bypass with isolated tricuspid valve disease. So even in a patient population that tends to be younger and patients with endocarditis or the tricuspid valve, um there's only about 500 of these operations performed in the country per year. Um And so the in the mortality rates are very high, approaching 10% despite it being a younger population. So, for decades, we haven't had a way to address this. Uh very prevalent, very uh a harmful uh problem of tricuspid regurgitation. And now we have two commercially available ways to fix those in a minimally invasive fashion. That's based on two large clinical trials that we participated in heavily and have quite a bit of the early experience with um that allow patients to stay out of the hospital uh to get significant reduction in their symptoms. Um and to head off, uh more serious problems like liver failure and and kidney failure. Um The first device is called a tri clip, which uh in the medical terminology is a tri cuspid edge to edge repair. This is very similar to another technology that we've been using for almost a decade, which is MitraClip, which is a mitral edge to edge repair. Um We're one of the largest centers in the country for MitraClip. Um the valve on the other side of the heart that separates blood returning from the lungs from the main pumping chamber. We've been able to treat those leaking mitral valves to significant effect and with excellent outcomes with this commercially available therapy therapy called MitraClip. So now that we have commercial availability and FDA approval of both of these devices, we have the opportunity to treat a tremendous amount of patients that really uh have what amounts to be an orphan disease that didn't have previous uh therapies that were appropriate. And so it's a tremendous opportunity for us to take care of a large large percentage of patients in the tide water area that don't have any other options.
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