Transcatheter tricuspid valve replacement (TTVR)

Transcatheter tricuspid valve replacement (TTVR) is a minimally invasive procedure to replace a damaged or malfunctioning tricuspid valve. The tricuspid valve helps control blood flow from the right atrium to the right ventricle of the heart, making sure blood moves in the proper direction and doesn’t flow backward.  

TTVR uses a thin, flexible tube called a catheter to deliver the replacement valve through a blood vessel and guide it to the heart. The new valve is compressed for delivery through the catheter, and then expanded once inside the tricuspid valve to take over its function. This less-invasive approach allows doctors to repair the heart without making a large incision in the chest and helps patients avoid the risks and longer recovery associated with traditional open-heart surgery. 

People living with tricuspid valve disease come to Penn Medicine for access to our nationally recognized heart surgeons and the latest advancements in cardiac care, including TTVR. As one of the largest heart valve disease programs in the Mid-Atlantic region, we treat every heart valve condition, from routine to highly complex cases. 

TTVR is typically recommended for people who are showing symptoms, have severe tricuspid valve disease, and are not good candidates for open-heart surgery as determined by the heart team. This may include people who are: 

• Older in age 
• Have additional health conditions 
• Have had previous heart surgeries 

Before the TTVR procedure, you may be given general anesthesia, which puts you into a deep sleep, or sedation, which helps you feel relaxed and comfortable. Either will keep you comfortable during the procedure, which includes the following: 

• A catheter is inserted through a blood vessel, usually in the groin, and guided to the heart. 
• The new valve is placed inside the damaged tricuspid valve via the catheter. 
• The catheter is removed, and the new valve begins working immediately to improve blood flow. 

The entire procedure usually takes a few hours, and you’ll be closely monitored throughout. Many people are up and walking within hours after the procedure. You’ll typically stay in the hospital for around one to two days after TTVR procedure. 

Full recovery time from TTVR can vary but is faster than traditional surgical approaches. You may experience some discomfort or tiredness, but these symptoms typically improve within a week or two. Your doctor will provide specific instructions for activity and follow-up appointments. Most patients can return to normal activities in a few weeks, while your heart health continues to be monitored. 

As with any medical procedure, TTVR carries some risks. These can include: 

• Bleeding 
• Infection  
• Blood clots 
• Damage to blood vessels 
• Heart block requiring a pacemaker to be placed 

In rare cases, the new valve may not work properly, or other heart complications may arise. Your doctor will discuss the risks with you before the procedure and answer any questions you have. 

With high patient satisfaction and a reputation for excellence, Penn Medicine is a trusted leader in heart valve care. We have one of the most experienced and skilled cardiology teams in the country. Our specialists use the latest technology and techniques to perform TTVR with precision and care.

With Penn Medicine, you can expect:

• Pioneers in catheter intervention: We were among the first in the Mid-Atlantic region to offer several advanced cardiac catheter treatment options, including transcatheter aortic valve replacement (TAVR), for which we are one of the top 5 centers in the nation for volumes and experience with this procedure.
• Expert surgical skills: Our cardiac surgeons routinely perform complex valve repair and replacement procedures.
• Accessible innovation: Penn Medicine is an international leader in developing new therapies for heart valve repair and replacement. Participation in our clinical trials gives patients access to new treatments based on the latest research.