Australian first TTVR marks milestone in structural heart disease

Australia’s first transcatheter tricuspid valve replacement (TTVR) using China-based Jenscare Scientific’s LuX-Valve system for carcinoid tricuspid valve disease has been performed by the Structural Heart Team at Epworth, marking one of the earliest reported cases globally.

The landmark procedure was undertaken by Professor Antony Walton, Interventional Cardiologist, and Dr Chris Anthony, Director of Cardiac Diagnostics and Imaging, for a patient with carcinoid heart disease. This is a cohort widely regarded as among the most challenging in structural heart intervention, where procedural success depends on far more than technical device implantation.

The case required pre-procedural planning incorporating CT, transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE), alongside careful haemodynamic optimisation and close multidisciplinary collaboration. Equally important was proactive mitigation of peri-procedural carcinoid crisis through coordinated octreotide infusion, together with integrated anaesthetic and intensive care management throughout the procedure.

A key element of the treatment strategy was a staged transcatheter approach, with transcatheter pulmonary valve replacement (TPVR) performed before TTVR. Sequential intervention enabled optimisation of right ventricular loading conditions and haemodynamics before treatment of the severely restricted and pathological tricuspid valve leaflets characteristic of carcinoid valve disease.

“TTVR is expanding the treatment landscape for carefully selected patients with carcinoid heart disease,” said Dr Anthony. “Cases such as this demonstrate the importance of precision imaging, thoughtful procedural sequencing, meticulous haemodynamic management, and true multidisciplinary collaboration in delivering successful outcomes for carefully selected patients who previously, had limited non-surgical therapeutic options.”

The LuX-Valve system is a direct competitor to the Evoque system from Edwards Lifesciences, which remains the only TTVR device approved by the Therapeutic Goods Administration (TGA) for the treatment of severe tricuspid regurgitation (TR). However, the Evoque system has not yet received Medical Services Advisory Committee (MSAC) approval for Medicare Benefits Schedule (MBS) listing.

While this represents the first Australian use of the LuX-Valve system for carcinoid tricuspid valve disease, early local experience with the LuX-Valve Plus system in patients with symptomatic severe TR has already been reported at Fiona Stanley Hospital and Sir Charles Gairdner Hospital in Western Australia.

Jenscare Scientific has also recently secured Medsafe approval for the LuX-Valve Plus in New Zealand and is actively advancing its commercialisation strategy alongside Ken-Valve, the company’s transcatheter aortic valve replacement (TAVR) device.

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