Percutaneous valve in valve in the tricuspid position in a patient with Tetralogy of Fallot

Challa, A.; Markham, R.; Walters, D.

doi:10.1136/bcr-2017-221104

Cited by 5 publications

(4 citation statements)

References 12 publications

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“…Given the short term bene t from valvuloplasty, the patient underwent a percutaneous valve-in-valve procedure with a 29mm Edwards Sapien XT in the existing 31mm Mosaic Valve (true internal diameter 26mm) with resolution of rightsided failure and improvement in diastolic mean gradient across the tricuspid valve from 15mmHg to 4mmHg. The patient was treated with dual antiplatelets for 6 months, followed by aspirin alone, and the details of this procedure have been previously published by the authors 3 .…”

Section: Past Medical Historymentioning

confidence: 99%

Tricuspid Balloon Valve Fracture and Valve-in-Valve-in-Valve in a patient with Tetralogy of Fallot

Challa¹,

Appadurai²,

Wijesekera³

et al. 2023

Preprint

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Background Tetralogy of Fallot is the most common form of cyanotic congenital heart disease, with patients often requiring repeated valvular interventions throughout their lifetime. Transcatheter intervention play an important role in this cohort, and have been incorporated into guidelines for the management of prosthetic pulmonary valve degeneration, with growing observational data of transcatheter procedures in the tricuspid position. Here we describe a patient with Tetralogy of Fallot where transcatheter procedures were utilized in a patient of high surgical risk. Case presentation A 32 year old female with a history of repaired Tetralogy of Fallot presented with treatment resistant right sided heart failure. She had previously undergone four sternotomies, resulting in a 31mm Mosaic valve in the tricuspid position, and a 25mm homograft in the pulmonary position. She had also underwent a tricuspid valve in valve procedure for severe bioprosthetic valve stenosis, which had re-stenosed after 4 years. She was discussed in a multidisciplinary meeting, and given her multiple previous sternotomies and morbid obesity, decision was made to attempt further percutaneous intervention. She successfully underwent a Tricuspid Valve-in-Valve-in-Valve procedure with a 29mm Sapien 3 valve. Six month follow up demonstrated favourable valve hemodynamics, along with improvement in symptoms of right sided heart failure. Conclusions Transcatheter procedures have had an evolving role in the management of patients with congenital heart disease. This case highlights the utility of transcatheter interventions in a patient of very high surgical risk. Although the long term durability of these interventions are yet to be determined in the literature, they play an important role in prolonging the lifespan of a surgical valve, which in turn reduces the total sternotomies patients undergo over their lifetime.

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Section: Past Medical Historymentioning

confidence: 99%

Tricuspid Balloon Valve Fracture and Valve-in-Valve-in-Valve in a patient with Tetralogy of Fallot

Challa¹,

Appadurai²,

Wijesekera³

et al. 2023

Preprint

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“…These patients often undergo multiple surgeries, and percutaneous intervention is an attractive option because the procedure can be complicated by multiple sternotomies[ 7 , 8 ]. Challa et al [ 9 ] described a case of successful percutaneous insertion of a transcatheter 29 mm Edwards Sapien XT valve into the tricuspid valve in a patient who underwent TOF repair[ 9 ]. Seckeler et al [ 10 ] reported the case of a high-risk patient with complex adult congenital heart disease who underwent successful percutaneous tricuspid valve-in-ring placement with a SAPIEN 3 valve.…”

Section: Introductionmentioning

confidence: 99%

Pulmonary and tricuspid regurgitation after Tetralogy of Fallot repair: A case report

Cao,

Ning,

Zhou

et al. 2023

World J Cardiol

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BACKGROUND Tetralogy of Fallot (TOF) is one of the most common congenital heart defects, and surgery is the primary treatment. There are no precise guidelines on the treatment protocol for tricuspid regurgitation (TR) as a common complication of TOF repair. The timing for treatment in patients presenting with valve regurgitation after TOF repair is often difficult to determine. Here, we report the first case of sequential treatment of pulmonary and TR using interventional therapy. CASE SUMMARY We present the case of a 52-year-old female patient, who had a history of TOF repair at a young age. A few years later, the patient presented with pulmonary and tricuspid regurgitation. The symptoms persisted and TR worsened following percutaneous pulmonary valve implantation. Preoperative testing revealed that the patient’s disease had advanced to an intermediate to advanced stage and that her general health was precarious. Because open-heart surgery was not an option for the patient, transcatheter tricuspid valve replacement was suggested. This procedure was successful, and the patient recovered fully without any adverse effects. This case report may serve as a useful resource for planning future treatments. CONCLUSION Treatment of both valves should be considered in patients with tricuspid and pulmonary regurgitations following TOF repair. The interventional strategy could be an alternative for patients with poor general health.

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“…Tricuspid valve dysfunction is a relatively uncommon occurrence, with a higher prevalence in individuals with congenital heart abnormalities, often involving complex patients and frequently quite debilitated. 2,3 Severe tricuspid valve dysfunction and especially severe regurgitation is associated with increased mortality independently from other factors. Surgical tricuspid valve replacement is the main indication for the treatment of severe tricuspid valve dysfunction (regurgitation, stenosis or mixed).…”

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confidence: 99%

“…2,3 Management of these patients is complicated by the presence of previous sternotomies, and a high surgical morbidity and mortality, which makes a percutaneous approach an appealing option. 2,3 The implantation of percutaneous valves in the tricuspid position is still an off-label indication, but it can be an option to avoid re-interventions on tricuspid bioprosthesis. Here, we describe a case of successful percutaneous tricuspid valve-in-valve procedure, with a 23-mm-Edwards Sapien S3 valve © in a 10 kg boy.…”

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confidence: 99%

2020

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Percutaneous valve in valve in the tricuspid position in a patient with Tetralogy of Fallot

Cited by 5 publications

References 12 publications

Tricuspid Balloon Valve Fracture and Valve-in-Valve-in-Valve in a patient with Tetralogy of Fallot

Tricuspid Balloon Valve Fracture and Valve-in-Valve-in-Valve in a patient with Tetralogy of Fallot

Pulmonary and tricuspid regurgitation after Tetralogy of Fallot repair: A case report

Tricuspid valve in valve procedure with an Edwards S3 valve^© in a 10 kg child

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Percutaneous valve in valve in the tricuspid position in a patient with Tetralogy of Fallot

Cited by 5 publications

References 12 publications

Tricuspid Balloon Valve Fracture and Valve-in-Valve-in-Valve in a patient with Tetralogy of Fallot

Tricuspid Balloon Valve Fracture and Valve-in-Valve-in-Valve in a patient with Tetralogy of Fallot

Pulmonary and tricuspid regurgitation after Tetralogy of Fallot repair: A case report

Tricuspid valve in valve procedure with an Edwards S3 valve© in a 10 kg child

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Tricuspid valve in valve procedure with an Edwards S3 valve^© in a 10 kg child