SARASOTA, Fla. (April 29, 2025) – Sarasota Memorial’s heart team is among the first wave of physicians using a new FDA-approved treatment that replaces failing tricuspid valves in patients who otherwise have limited, if any, options.
In separate procedures, SMH interventional cardiologists Ricardo Yayura, MD, Jeffrey Rossi, MD, and Fabio Lima, MD, completed transcatheter tricuspid valve replacements (TTVR) on four patients who had been suffering from tricuspid regurgitation for some time, but were too high-risk for surgical repair or replacement due to age or the anatomy of their heart. All four patients received the new valves in a less invasive, catheter-based approach in SMH’s cardiac catheterization lab.
“We are very excited to bring this new treatment – and new hope -- to people living with serious tricuspid regurgitation in our community,” said Dr. Yaryura, medical director of Sarasota Memorial’s cardiac catheterization team. “In the past, all we could do for people with severe leakage who were too high risk for surgery was manage their symptoms with medications. But medications often are not enough and over time, the condition can worsen and lead to heart failure or other life-threatening complications.”
The tricuspid valve historically has been one of the more technically challenging valves to treat because of its location in the back of the heart and surgical risks. That’s why the EVOQUE Tricuspid Valve Replacement System from Edwards Lifesciences -- the world’s first and only approved TTVR system -- is such a groundbreaking advance in non-surgical heart care, said Dr. Rossi.
“The Evoque TTVR system is a less invasive option that does not require open heart surgery,” Dr. Rossi said. “The procedure typically takes two hours, and most patients recover quickly and are discharged home within two to three days, with significant improvement in symptoms and quality of life.”
The catheter-based treatment was approved by the FDA in 2024, and last month the U.S. Centers for Medicare & Medicaid approved reimbursement for the treatment. Physicians and hospital teams implanting the valves complete specialized training, and patients are carefully evaluated to ensure they meet medical criteria. At Sarasota Memorial, cardiac surgeons Jonathan Hoffberger, DO, and Kristen Walker, MD, collaborate alongside the cardiologists on TTVR procedures.
The timing of the FDA approval was pivotal for Glenridge retiree Bob Fernander, who had been suffering from tricuspid regurgitation and shortness of breath for the past several years. The 94-year-old was not a candidate for a surgical repair or replacement due to his risk factors, and as his condition worsened, he gradually scaled back every activity he enjoyed, including visiting his two sons and grandchildren in California and Indiana.
“I was afraid to travel,” said Fernander. “I couldn’t walk 10 steps without having to find a place to sit down. I couldn’t bend down to tie my shoes or even put a collar on my dog without feeling faint. I certainly didn’t want to have a medical emergency while traveling.”
Fernander was being evaluated for a clinical trial last year when the FDA approved the EVOQUE system. In January, he became the first patient at SMH to receive the new valve, implanted by Dr. Yaryura. Three other patients underwent the procedure in the past week. All are doing well.
“I noticed a dramatic difference in just a few days,” he said. “For the first time in a long while, I felt normal. Someone joked that the valve came with a lifetime warranty, or at least an extended warranty. I told them I’d take either.”
Joking aside, he said, his quality of life has dramatically improved. He enrolled in the cardiac rehab program at SMH’s HealthFit and is exercising on a stationary bike and treadmill without any heart or respiratory issues. The best part, he said, is the opportunity to travel and resume the activities he once enjoyed. He has several trips planned this summer, including attending his granddaughter’s wedding in Indiana in June, a cruise with his sweetheart in August and the upcoming birth of his first great-grandchild.
About Tricuspid Regurgitation
According to National Institutes of Health, an estimated 1.6 million people in the U.S. have been diagnosed with tricuspid regurgitation, where the tricuspid valve does not close properly, and blood is allowed to flow backward into the right atrium. If left untreated, the condition may lead to complications that include heart failure, pulmonary hypertension, enlarged right atrium, arrhythmias, reduced blood flow to lungs and liver dysfunction.
About Sarasota Memorial Health Care System
Sarasota Memorial Health Care System is a regional medical center offering Southwest Florida’s greatest breadth and depth of care, with 2,500 physicians and advanced practice providers and nearly 2 million patient visits a year across its network of care. Sarasota County’s largest employer, the community-owned health system includes two full-service hospitals in Sarasota and Venice, freestanding ERs in North Port and Lakewood Ranch, a rehabilitation hospital, behavioral health hospital, skilled nursing facility and comprehensive network of outpatient centers, urgent care clinics and physician practices. Founded in 1925, SMH is celebrating its 100-year anniversary in 2025 and encouraging community members to visit smh.com/100 throughout the year for centennial events and updates.