In this episode of Nail it with Nadira, Dr Neil Fam discusses the Topaz TTVR system, a tricuspid-specific transcatheter valve replacement platform designed to conform to native anatomy while minimizing radial force and conduction-system interaction. He walks through the device’s two-stent design, transfemoral and transjugular implant options, leaflet-independent deployment, and the early clinical experience that continues to shape patient selection and procedural strategy.

The conversation also highlights a real-world compassionate-use case in a patient with torrential functional TR and an ICD lead crossing the valve, illustrating how the platform can be used in complex anatomy. Dr Fam then reviews the evolving clinical program, including early feasibility data, the expanding European and North American experience, and the newly launched pivotal study comparing Topaz with Edwards EVOQUE.

Hear how an expert operator interprets the features that may matter most in clinical practice: soft-frame design, low pacemaker rates, anatomic conformity, and the practical limitations that still influence candidacy for TTVR.