OSF HealthCare Saint Francis Medical Center is now offering a cutting-edge, minimally invasive option called TriClip for patients suffering from tricuspid regurgitation.

Introducing TriClip

"We have a percutaneous (through the skin) option of fixing tricuspid regurgitation, leakiness of the tricuspid valve. That procedure is called TriClip," says Sudhir Mungee, MD, an interventional cardiologist and director of the structural heart division of OSF HealthCare Cardiovascular Institute who along with Ashvarya Mangla, MD, and Marco Barzallo, MD, performs these procedures at OSF Saint Francis Medical Center. "It is similar to MitraClip, but in the tricuspid valve position."

The heart is divided into four chambers: two upper chambers and two lower chambers.

Subsequently, the heart contains four valves: aortic, pulmonary, mitral and tricuspid. These valves can become narrow (stenosis) or leaky (regurgitation); either condition is detrimental to patients and can cause heart failure.

TriClip was started in early 2025 and adds on to the already robust structural heart program at OSF HealthCare. OSF launched a transcatheter aortic valve replacement (TAVR) program back in 2012, treating aortic valve disease (aortic stenosis). 

In 2021, OSF Saint Francis launched the MitraClip program. This is impactful when the mitral valve, located on the left side of the heart, gets leaky. Often seen in people with left-sided heart disease, kidney disease or a dilated heart, tricuspid regurgitation has been rarely alone treated surgically due to the risks involved. 

The TriClip program at OSF Saint Francis changes that. 

"Imagine there are three leaflets of a valve that need to come together and close the valve. If the leaflets are not coming together, there will be gaps left, which will cause leakiness of the blood in the lower right chamber, to the top right chamber," Dr. Mungee says. "TriClip is actually a clip that holds the leaflets together, so the leakiness can be reduced." 

Serious challenges of tricuspid regurgitation

Tricuspid regurgitation is not just uncomfortable – it’s dangerous.

"Leakiness of the tricuspid valve can lead to right-sided heart failure," Dr. Mungee says. "It weakens the right side of the heart muscle and causes patients to have fluids in the belly or swelling in the legs. It decreases the quality and quantity of life significantly."

TriClip has been proven to have better patient outcomes than medical management alone, Dr. Mungee says, thanks to previous clinical trials. 

A proven track record

Dr. Mungee further mentions that the structural heart team at OSF Saint Francis has performed nearly 2,000 TAVR procedures and at least 150 MitraClip procedures. OSF Saint Francis’ structural heart division also has expertise in performing these procedures in previously failed surgical valves and can perform the unique technique of carotid artery access when the leg arteries are too narrow. This poised the structural heart division to launch the TriClip program in spring 2025. OSF Saint Francis is one of the very few medical centers in Illinois to treat patients with tricuspid valve issues.

Imaging of these valves is done using transesophageal echocardiogram (TEE) and intracardiac echocardiography (ICE), two different imaging procedures to get a better look at patients' hearts for successful outcomes.

To perform a TriClip procedure, Dr. Mungee says it takes a comprehensive team to make it happen. That includes cardiac imaging specialists, structural heart interventionalists, heart surgeons and the heart failure team at OSF Saint Francis. 

Three TriClip procedures have already been successfully performed at OSF Saint Francis so far. 

What to watch for

Dr. Mungee says the major health concerns for potential tricuspid valve patients would be swelling in the legs, buildup of fluid in the belly, or you have weakness and shortness of breath due to having a leaky valve. Start by making an appointment with your primary care provider (PCP) or cardiologist with such symptoms. It's important to specify which heart valve it is and then be referred to the structural heart team to evaluate the best options.

One of the most impressive aspects of the TriClip and similar procedures is the speed and ease of recovery.

"Most of our patients who get a new valve (TAVR), a MitraClip or a TriClip, come the day of the procedure, and the procedure lasts 1-3 hours. This is followed by a recovery period of 1-2 hours, and then they should be sitting and walking by the end of the day," Dr. Mungee says. “The next day, 98% to 99% of patients are discharged home with no skin cut. We put the sutures from the outside in, so it's like a pinhole in the groin that we put our instruments through and get the job done."

If you're diagnosed with a tight valve (valvular stenosis) or a leaky valve, you could then be referred to a structural interventionalist.

Dr. Mungee says the persistent work at OSF Saint Francis to put together the right teams has allowed for a robust heart program to flourish at the OSF Cardiovascular Institute and OSF Saint Francis. This has allowed a larger number of patients with more complex health issues to be able to receive world-class care in Peoria. Dedicated valve coordinators help patients all along the way; before, during and after procedures. 

"It takes a village to take care of patients with a lot of complexities," Dr. Mungee says. "This is why we are striving towards being a destination center, along with a center of excellence, for our valve patients."

To learn more about heart conditions treated at OSF, visit the OSF HealthCare website.

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Heart valve disease, which happens when one or more of your heart valves don’t work properly, is becoming an increasing problem among older adults.

According to the American College of Cardiology, every year about five million people in the country are diagnosed with valvular heart disease (VHD), with nearly 25,000 people dying from it.

February 22 is National Heart Valve Disease Awareness Day, a day during American Heart Month to raise awareness of the risks, symptoms and treatment options available for patients.

“Valvular heart disease is an important issue to recognize and treat, given the repercussions they may have for patients’ health," says Dr. Alejandro Aquino, a structural heart specialist with OSF Cardiovascular Institute. "We currently estimate more than 2% of patients have some degree of valvular heart disease, and it’s a growing problem and a problem that we understand is unrecognized and undertreated.”

Anyone can experience a heart valve issue and the risk increases as you get older. You may be at a greater risk if you’ve had a heart attack or heart failure, or have a risk for coronary heart disease.

“There are four valves in the heart," says Dr. Aquino. "The tricuspid valve, pulmonic valve, mitral valve, and aortic valve. And they function as one way doors keeping the blood going from chamber to chamber as it returns from the body, travels to the lungs to exchange for oxygen, and then returns to the heart and then ultimately is pumped to the body to deliver oxygen to all the tissues.”
 

HVD can develop quickly or over a long time. Symptoms may include:

·         Shortness of breath

·         Chest pain

·         Fatigue

·         Dizziness or fainting

·         Fever

·         Rapid weight gain

·         Irregular heartbeat

“Oftentimes, these changes are subtle, and the first people to notice are actually the patients' families," says Dr. Aquino.  "And when they come to visit they might be the person to say ‘hey, you know my dad or mom is not quite moving as well as they did six months ago, or last time I saw them. They were doing a lot more around the house or a lot more for fun or going out of the house for hobbies.’ So, again, it’s important to recognize that some of these symptoms can be quite subtle. Often a lot of my patients come and they say ‘well, I thought I was just getting older.’ When in reality it is their valve encroaching on their ability to do certain activities.”

HVD is treated either by medication or if it’s causing severe symptoms, surgery may be the better option. Dr. Aquino says recent advancements have given patients the option of replacing a valve by catheter instead of surgery. He adds that it’s best to be seen by a cardiologist to make those determinations.

"From my personal perspective, I think the earlier is better," says Dr. Aquino. "Most of my patients or a lot of patients that are referred to me have only mild or moderate forms of valvular heart disease. However, it's important for them to recognize exactly what's going on with their heart. And it's important for us to establish a surveillance plan so that when the time comes for there to be a fix, the patient is fully engaged and understands the process.”

The bottom line is to listen to your body. If you notice or experience any abnormal symptoms, contact your physician as soon as possible.

“The most important message is awareness," says Dr. Aquino. "Awareness of the prevalence of valvular heart disease, awareness of the important repercussions they may have to your health, of the importance of being tied into a cardiovascular specialist to perform initial evaluation and determine an appropriate surveillance or treatment plan. If you have any concerns, please contact your primary care provider.”

For more information on heart care, visit OSF HealthCare. 


 

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