TRICUS STUDY Euro - Safety and Efficacy of the TricValve® Device

Inclusion Criteria: 1. The subject must be 18 years of age or older 2. The subject must be a patient with severe symptomatic tricuspid regurgitation demonstrated by echocardiography with significant backflow in the lower (IVC) and/or upper (SVC) vena cava and with a v-wave ≥ 25 mmHg as demonstrated by right heart catheterization (measured in the IVC and/or SVC 2-4 cm above/ below RA inflow) within 8 weeks prior to the implantation 3. Suitable for TricValve® Transcatheter Bicaval Valves System implantation according to anatomic criteria by computed tomography 4. The subjects must have severe, tricuspid regurgitation leading to NYHA class III or IV 5. The subject has LVEF ≥ 40% 6. Distance covert in 6-minute walk test (6MWT) ≥ 60m 7. The patient shall be screened by a "Heart Team" - including an interventional cardiologist, cardiothoracic surgeon, and agreed as a candidate for TricValve® Transcatheter Bicaval Valves System implantation 8. Patient/authorized legal guardian understands the nature of the procedure, is willing to comply with associated follow-up evaluations, and provides written informed consent 9. Patient/patient's authorized legal guardian is geographically stable (or willing to return for required study follow-up) and understands and is willing to fulfil all of the expected requirements of this clinical protocol 10. Optimal medical treatment of patient Exclusion Criteria: 1. Known significant intracardiac shunt (e.g. ventricular septal defect) or congenital structural heart disease based on heart teams decision 2. Requirement for other elective cardiac procedures e.g. PCI (percutaneous treatment of coronary artery) or CABG (coronary artery bypass surgery) up to 90 days after the procedure or 30 days before the procedure 3. Right ventricular failure (TAPSE ≤13mmHg) 4. Systolic pulmonary arterial pressure \> 65 mmHg as assessed by Doppler echocardiography 5. Presence of any known life threatening (non-cardiac major or progressive disease), non-cardiac disease that will limit the subject's life expectancy to less than one year 6. Cerebro-vascular event within the past 3 months 7. History of mitral/tricuspid endocarditis within the last 12 months 8. Patient has untreated significant left sided valvular heart disease which requires treatment (e.g. mitral regurgitation or stenosis, and aortic regurgitation or stenosis) 9. Documented primary coagulopathy or platelet disorder, including thrombocytopenia (absolute platelet count \<90k) 10. Documented evidence of significant renal dysfunction (serum creatinine \> 3.0mg/dl) or on any form of dialysis at time of screening within the last 4 weeks 11. Contraindication or known allergy to device's components, anti-coagulation therapy with vitamin K antagonists or contrast media that cannot be adequately premedicated 12. Patients unsuitable for implantation because of thrombosis of the lower venous system or vena cava filter 13. The patient has contraindication against a transesophageal echo (TEE) during the procedure 14. Evidence of an acute myocardial infarction (AMI) ≤ 1 month (30 days) 15. Liver cirrhosis Child C (see appendix) 16. Female patient of child-bearing potential 17. Psychiatric or behavioural disease including known alcohol or drug abuser that is likely to impair compliance with protocol 18. Currently participating in another study of an investigational drug or device that would directly impact the treatment or outcome of the current study 19. Requirement for antibiotic treatment within the last 48 hours