Tricuspid Cardiopulmonary Exercise Study

Inclusion Criteria: * Chronic tricuspid regurgitation 2+ to 4+ on a scale of 4+ (moderate to severe) with annular diameter ≥ 40 mm with valve systolic pulmonary pressure (sPAP) ≤ 60 mmHg * New York Heart Association (NYHA) Class II-IV * Symptomatic despite Guideline Directed Medical Therapy (GDMT); at minimum patient on diuretic regimen * Left ventricular ejection fraction ≥ 30% * Symptomatic despite Guideline Directed Medical Therapy (GDMT); at minimum patient on diuretic regimen * The local site Heart Team concur that surgery will not be offered as a treatment option * Written informed consent in accordance with Good Clinical Practice (GCP) and local legislation Exclusion Criteria: * Inability to perform cardiopulmonary exercise test * Aortic, mitral and/or pulmonic valve stenosis and/or regurgitation ≥ moderate * Previous tricuspid valve repair or replacement * Severe precapillary pulmonary hypertension (PVR\>6 WE) * Cerebrovascular accident (CVA) within the past 6 months * Presence of trans-tricuspid pacemaker or defibrillator leads which cause impingement of the tricuspid valve leaflet as evaluated by echocardiography * Subject is on chronic dialysis and/or anemia (Hb \< 9 g/L) * Myocardial infarction or known unstable angina within 30 days prior to the index procedure * Any percutaneous coronary intervention or transcatheter valvular intervention within 30 days prior to the index procedure or planned 3 months post the index procedure * Previous tricuspid valve repair…