Transcatheter tricuspid valve implantation with LuX-Valve utilizing a novel patient-specific virtual and physical simulator: a case report

Background: The rise of transcatheter tricuspid valve implantation (TTVI) therapies represents a major advancement for high-risk patients with severe tricuspid valve regurgitation, offering a safer, minimally invasive alternative to open-heart surgery. However, the low volume of procedures and training highlights an urgent need for skills development and pre-procedural preparation, which simulation can address by enhancing learning and expanding treatment availability.

Case summary: An 87-year-old woman with permanent atrial fibrillation and symptomatic severe functional tricuspid regurgitation underwent a transcatheter tricuspid valve replacement with the LuX-Valve system. We developed a novel patient-specific virtual reality simulator, combining virtual and physical simulations, to enhance training and education for TTVI. This system utilizes high-resolution computed tomography images, machine learning algorithms, and a video game engine to recreate realistic procedural environments. We performed a safe intervention following the simulation session, achieving successful clinical outcomes in the patient.

Discussion: The developed platform is the first to propose a patient-specific hybrid simulation for TTVI engaging both interventional and imaging cardiologists. The simulator's potential to improve clinical and safety outcomes warrants further evaluation through specifically designed comparative studies.