The Tricuspid Valve Was Forgotten for Decades. TRiCares Is Changing That with Ahmed Elmouelhi

In this episode, Jordan is joined by Ahmed Elmouelhi, President & CEO of TRiCares, the company behind Topaz, a purpose-built transcatheter tricuspid valve replacement system now in head-to-head pivotal trial against Edwards EVOQUE in the US. Ahmed brings over 20 years of structural heart experience, including nearly a decade building TAVR and LAA therapies at AtriCure and Medtronic, and explains exactly why he crossed to the right side of the heart and what it took to build a valve that doesn't behave like anything the field has seen before. Key Topics: Why the tricuspid valve was "the forgotten valve" for decades and what changed The design philosophy behind Topaz: building a soft, flexible valve purpose-built for the right side of the heart Going head-to-head with Edwards EVOQUE in the TRICURE US IDE pivotal trial What the first 20 patients taught TRiCares the good, the bad, and the ugly Running dual CE mark and US pivotal studies simultaneously, and what that demands from leadership and board The three things TRiCares hires for: hungry, humble, and smart Related Insights: Why more than 25% pacemaker rates in current TTVR systems are clinically and economically untenable How ICE-based (intracardiac echo) guidance is reducing procedural imaging burden and removing the need for general anaesthesia The "smooth is fast, slow is smooth" operating philosophy borrowed from Formula One What physicians should look for when choosing which TTVR pivotal study to join Core Challenges: The tricuspid annulus is highly variable in anatomy and extremely low-pressure, everything that works in aortic and mitral valve replacement has to be unlearned when building for the right side of the heart. The current commercial standard (Edwards EVOQUE) carries a pacemaker implant rate exceeding 25%, often appearing after discharge, a clinical, economic, and patient safety problem that TRiCares is targeting with a reported 0% rate from its soft outer shell design. Running two concurrent pivotal trials across the US and Europe while building out a team, infrastructure, and physician network is a resource and execution challenge that demands an experienced, aligned board. Tune in now to hear why Ahmed believes the tricuspid space has the potential to outgrow TAVR and what it will take to get there.