Tresquare Technologies develops TRESECT® platform to address challenges in Valve-in-Valve procedures

Bioprosthetic heart valves inevitably degenerate over time, making repeat interventions necessary for many patients. However, in aortic Valve-in-Valve (ViV) procedures, calcified valve leaflets can reduce the effective orifice area, obstruct coronary arteries, and compromise the durability of the replacement valve. To help overcome these challenges, Italian MedTech company Tresquare Technologies has developed TRESECT®, a next-generation transcatheter platform designed to resect and extract degenerated aortic valve leaflets before Valve-in-Valve procedures while maintaining continuous blood flow throughout the intervention using a dedicated temporary valve system.

How TRESECT® works

TRESECT® combines three technologies into a single integrated platform: a leaflet capture mechanism, a dedicated mechanical resection system, and a guidewire-based temporary valve. According to the company, the temporary valve maintains patient hemodynamic stability throughout the procedure while the diseased leaflets are resected and removed, allowing clinicians to proceed with Valve-in-Valve implantation. The system has also been designed to integrate with standard transcatheter aortic valve implantation (TAVI) workflows.

The company says the platform enables precise circular leaflet resection, secure capture and retrieval of excised tissue, and continuous blood flow during the intervention, with the aim of improving procedural safety in complex cases.

Development progress

Tresquare Technologies has already completed several development milestones for TRESECT®. These include extensive in vitro validation, optimisation of the fifth-generation prototype, protection of four international patent families, and development of a complete delivery system intended for ongoing animal studies. An example of the in vitro leaflets resection effect is shown below:

Addressing a growing market

The company believes demand for leaflet modification technologies will continue to grow alongside increasing adoption of transcatheter valve replacement procedures. TAVI-in-TAVI procedures are expected to increase from more than 42,000 cases today to over 115,000 annually by 2035, representing a potential market exceeding $2 billion.

Tresquare Technologies also notes that there are currently no direct commercial competitors offering a dedicated leaflet modification platform, positioning TRESECT® as a potential solution for an emerging segment of structural heart interventions.

Looking ahead

With preclinical development continuing, Tresquare Technologies is preparing for ongoing animal studies while advancing TRESECT® toward its next stages of development. By combining leaflet capture, mechanical resection, and temporary hemodynamic support into a single platform, the company aims to address longstanding challenges associated with Valve-in-Valve procedures and improve outcomes for patients requiring repeat aortic valve interventions.

Up next: MedTech World Asia 2026 | Hong Kong

Catch Stefano Pasquino, CEO of Tresquare Technologies, in action during the Company Showcase at MedTech World Asia 2026 | Hong Kong, taking place from 26–28 August. Discover how TRESECT® is addressing challenges in Valve-in-Valve procedures and hear directly from the company behind the technology.

Beyond the Company Showcases, the three-day event features the headline Startup Pitch Competition, the MedTech World Awards Gala, a dedicated 1:1 Networking Area powered by MedTech World Match, expert-led panel discussions, investor meetings, and much more. Explore the full agenda and secure your place if you haven’t already.