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Part 1 | Session 1 Welcome and Introduction
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Part 1 | Session 2 Dr Kodali on VDyne TTVR, Device Design, and Early Clinical Experience
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Part 1 | Session 4 Dr Zahr on the Evolution of Intrepid TTVR and the Next Pivotal Trial
In this final chapter of this session, Dr Nadira Hamid, Prof Nicolas Van Mieghem and a panel of leading tricuspid intervention experts explore the future of transcatheter tricuspid valve replacement (TTVR), from evolving imaging strategies to the growing debate between repair and replacement therapies.
The discussion examines whether advances in intracardiac echocardiography (ICE) and 3D imaging could reduce reliance on transoesophageal echocardiography and general anaesthesia, potentially enabling simpler, conscious sedation-based TTVR procedures. Faculty share how their own platforms are adapting to changing imaging workflows and what this could mean for procedural efficiency and patient recovery.
The panel also tackles some of the field’s most important unanswered questions: Should TTVR be compared with medical therapy, transcatheter edge-to-edge repair (TEER) or other replacement platforms? Will different valve systems serve complementary roles, or will a smaller number of technologies ultimately dominate clinical practice? And how should clinicians balance the procedural safety of TEER against the more complete elimination of tricuspid regurgitation often achieved with valve replacement?
Hear candid perspectives from experienced operators on patient selection, leaflet thrombosis, anticoagulation, recurrent TR after repair, right ventricular remodelling and the importance of building a future toolbox of therapies tailored to individual patients. The faculty also review audience polling results and reflect on how ongoing pivotal trials may shape the next era of personalised treatment for tricuspid valve disease.
As the session concludes, the experts look ahead to a rapidly evolving landscape where improved imaging, expanding clinical evidence and multiple competing TTVR platforms could transform care for patients with severe tricuspid regurgitation.
Part of the Nail It with Nadira series, this programme explores the rapidly evolving field of transcatheter tricuspid valve replacement (TTVR) through practical, expert-led discussions.
Join Dr Nadira Hamid, Prof Nicolas Van Mieghem, Dr Firas Zahr, Dr Susheel Kodali, Dr Neil Fam and Dr Kashish Goel as they examine emerging TTVR technologies, including Intrepid, VDyne, Topaz, LuX and Laplace. Across a series of focused segments, the faculty discuss patient selection, imaging, procedural planning, device design and the role of TTVR within contemporary tricuspid treatment pathways.
Designed for structural heart specialists and Heart Team members, the series provides practical insights into how leading centres are evaluating and preparing to integrate next-generation TTVR platforms into clinical practice.
Watch the episodes, explore the latest developments in tricuspid intervention and join the conversation by sharing your perspectives on the future of TTVR.
More from this programme
Part 1
Faculty Biographies
Nadira Hamid
Cardiologist & Director of the Echocardiography Core Laboratory
Dr Nadira Hamid is a non-invasive cardiologist specialising in advanced echocardiography and structural heart disease. She is Director of the Echocardiography Core Laboratory at the Minneapolis Heart Institute Foundation in Minneapolis, Minnesota, where she supports structural heart and valvular disease programmes through multimodality cardiac imaging.
Her clinical practice focuses on echocardiography-guided assessment and imaging support for transcatheter structural heart interventions, including aortic, mitral, and tricuspid valve procedures.
Current Roles and Responsibilities
Since January 2024, Dr Hamid has served as Director of the Echocardiography Core Laboratory at the Minneapolis Heart Institute Foundation. In this role, she oversees echocardiography imaging protocols, quality assurance, and clinical imaging support for structural heart disease and valvular heart disease programmes.
She works within a multidisciplinary heart team, integrating…
Nicolas M Van Mieghem
Full Professor of Interventional Cardiology
Prof Van Mieghem initially intended to train as a cardiac surgeon but decided to specialise in interventional cardiology instead, following advice from a mentor. This decision was cemented when he read the first-in-human case report of transcatheter aortic valve implantation (TAVI) in Circulation by Alain Cribier in 2002. Prof Van Mieghem believes that great cardiologist genuinely cares for their patients. He names Gary Roubin, Dr Manu Malbrain and Professor Patrick Serruys among his mentors.
Academic History
Prof. Nicolas M. Van Mieghem completed his medical training at the Catholic University of Leuven (Belgium), where he earned both his medical degree and his specialist degree in cardiology. During his time in Leuven, he developed a strong interest in cardiovascular medicine, particularly in the emerging field of minimally invasive cardiac interventions. After finishing his core medical and cardiology training, he pursued multiple advanced…
Firas Zahr
Director of Interventional Cardiology and Associate Professor of Medicine
Dr Firas Zahr is an Associate Professor of Medicine in the Division of Cardiovascular Medicine at Oregon Health and Science University. At the same institution, he is the Director of Interventional Cardiology and Co-Director of the Structural Heart Disease program.
Dr Zahr earned his MD from the University of Damascus in 2002 and has been in practice for more than 20 years. He further specialised with an Interventional Cardiology Structural Fellowship at the University of Pittsburgh Medical Center.
He is a Fellow of the American College of Cardiology, and his research focuses on cardiac catheterization, transcatheter valve therapies and interventional cardiology. Alongside his investigations, Dr Zahr has written over a hundred publications in peer reviewed journals focusing on valvular heart disease management.
Kashish Goel
Advanced Structural/interventional fellow
Dr. Goel, MD is a practicing Cardiologist (Heart Specialist) in Rochester, MN. Dr. Goel graduated from Maulana Azad Medical College University of Delhi in 2010 and has been in practice for 9 years. He completed a residency at Wayne State University. Dr. Goel also specializes in Internal Medicine. He currently practices at Mayo Clinic Obstetrics & Gynecology and is affiliated with Mayo Clinic Health System Eau Claire. Dr. Goel accepts multiple insurance plans including Aetna, Medicare, and Cigna. Dr. Goel is board certified in Internal Medicine.
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