Percutaneous tricuspid valve‐In‐ring replacement for the treatment of recurrent severe tricuspid regurgitation

Condado, José F.; Leonardi, Robert A.; Babaliaros, Vasilis

doi:10.1002/ccd.25980

Cited by 19 publications

(9 citation statements)

References 12 publications

(11 reference statements)

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“…Both transcatheter subpulmonic tricuspid or systemic mitral valve replacement have been successfully performed, whether valve‐in‐ring or valve‐in‐valve. Some reported challenges include outflow tract obstruction for the mitral position due to the aorto‐mitral fibrous continuity, perivalvular regurgitation due to the asymmetric annulus/ring, large delivery systems, and high dislodgement forces in the systemic AV valve position . Per our knowledge, this is the first reported transcatheter systemic TV‐in‐ring replacement in a patient post Mustard repair.…”

Section: Discussionmentioning

confidence: 89%

Trans‐apical systemic tricuspid valve‐in‐ring replacement

Ghobrial

Reemtsen

Levi

et al. 2018

Cathet Cardio Intervent

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Transcatheter valve replacement offers a safe and effective alternative to traditional surgical techniques in patients with congenital heart disease, especially those at high surgical risk. The most common causes of morbidity and mortality in patients with D-transposition of the great arteries status post Senning or Mustard repair is severe tricuspid valve (TV) regurgitation.Replacement of the systemic TV may be useful in those without severe systemic ventricular dysfunction. We present a case of a patient with D-loop transposition of the great arteries status post Mustard repair and TV ring placement with subsequent severe systemic TV regurgitation, at high surgical risk, who underwent a transcatheter valve replacement via a trans-apical approach using an Edwards Sapien XT valve.

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Section: Discussionmentioning

confidence: 89%

Trans‐apical systemic tricuspid valve‐in‐ring replacement

Ghobrial

Reemtsen

Levi

et al. 2018

Cathet Cardio Intervent

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“…Valve-in-ring THV implantation for failed surgical tricuspid annuloplasty repair is a rare procedure reserved for patients at high risk for reoperation. Case reports have demonstrated feasibility, but complications include leaflet entrapment (requiring further THV implantation 10 ) distal wire perforation, 11 residual severe TR necessitating vascular occlusion devices, 7 , 8 , 10 or emergency open heart surgery. 12 …”

Section: Discussionmentioning

confidence: 99%

Transcatheter valve-in-ring and para-ring vascular plug implantation for severe tricuspid regurgitation following annuloplasty ring failure: a case report

Sharma

Nadir

Steeds

et al. 2022

European Heart Journal - Case Reports

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Background Moderate or severe tricuspid regurgitation (TR) recurs in up to one-third of patients within 8 years of surgical annuloplasty repair. Reoperation often carries high risk with poor outcomes. Transcatheter valve-in-ring repair is an emerging alternative treatment. However, residual regurgitation is frequent and may necessitate further procedures. Case summary A 52-year-old female was diagnosed with severe rheumatic valvular heart disease. The patient underwent mechanical aortic and mitral valve replacement. Additionally, tricuspid repair was performed using a semi-rigid annuloplasty ring (28 mm Edwards Physio Tricuspid). Within 2 years, the patient developed recurrent, isolated severe symptomatic TR, with progressive right ventricular dilatation. The patient was considered prohibitive risk for redo surgery and unsuitable for cardiac transplantation. She underwent percutaneous valve-in-ring transcatheter heart valve implantation (THV) using a 29 mm Sapien S3 (Edwards Lifesciences, California, USA) valve. Persistent severe residual para-ring TR warranted a further procedure to deploy vascular plugs, significantly reducing the TR to a mild jet with symptomatic improvement. Discussion Valve-in-ring THV implantation for failed surgical tricuspid annuloplasty repair is a rare procedure reserved for symptomatic patients at high or prohibitive risk for reoperation. Significant residual TR is a commonly encountered problem with incomplete annuloplasty rings following valve-in-ring procedures and may occur either intra-ring between the THV and the ring or para-ring. Implantation of vascular occlusion devices can be used to successfully treat residual TR at either location with good outcomes at 6-month Follow-up. Further work is required to determine the longevity of this treatment.

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“…Off-label transcatheter valve-in-valve implantation of the SAPIEN 3 aortic bioprosthesis (Edwards Lifesciences) is a safe and effective treatment option in patients with a degenerating surgical tricuspid bioprosthesis 81 , while suboptimal results have been observed after tricuspid valve-in-ring procedures 82,83 .…”

Section: Transcatheter Tricuspid Valve Replacementmentioning

confidence: 99%