Concomitant transatrial valve‐in‐valve in pulmonal and tricuspid position

Abstract

Transcatheter valve implantation in the pulmonary valve has been established as a valuable treatment option for patients with conduit failure in the right ventricular outflow tract, most often with the use of the Melody valve. Transcatheter valve-in-valve (VIV) implantation in the tricuspid position is restricted to single case reports, most often with the implantation of the Edwards SAPIEN valve. A 67 years old male with carcionoid syndrome and previously implanted bioprosthesis in the pulmonary and tricuspid valve now presented with worsening symptoms due to degeneration of both bioprostheses. The risk of new open surgery was deemed to high. We report of the first transatrial double VIV implantation using the balloon expandable Edwards SAPIEN XT in pulmonary and tricuspid position.

Transcatheter native pulmonary valve and tricuspid valve replacement with the sapien XT: Initial experience and development of a new delivery platform

“…The 29 mm Sapien XT valve is significantly larger than a maximally expanded Melody valve. Thus, the 29 mm Sapien XT valve has the potential to be used off‐label for transcatheter pulmonary valve replacement in selected patients with RVOT's too large for the Melody valve . While the Sapien XT transcatheter aortic valve can be used off‐label for large diameter pulmonary valve replacement , its delivery system is custom designed for aortic valve replacement and its limited flexibility makes it extremely difficult to use for pulmonary valve replacement.…”

Simultaneous transcatheter pulmonary and tricuspid valve‐in‐valve implantation for the treatment of failing pulmonary and tricuspid bioprostheses

“…Jux et al reported on the first percutaneous transcatheter double VIV implantation on the tricuspid and pulmonary positions using the melody valves in a 26‐year‐old man with Tetralogy of Fallot . Later, Dahle et al used trans‐atrial approach to perform transcatheter double VIV implantation on pulmonary and tricuspid positions using Edwards SAPIEN valves . To our knowledge, the case presented herein is the first case on the concomitant pulmonary and tricuspid VIV implantation using Edwards SAPIEN valves by percutaneous transcatheter techniques.…”

Expanding Indications of Transcatheter Heart Valve Interventions

“…However, as is the case for the indications previously described, the use of the Melody valve is limited by its small size and the risk of stent fracture. For these to be feasible (106,110). As an alternative access, a surgical subxiphoid approach through the right ventricle has been proposed (111).…”