Transcatheter tricuspid valve-in-valve implantation for very early bioprosthetic tricuspid stenosis secondary to pacemaker lead entrapment: a case report

Abstract

Background Tricuspid stenosis (native and prosthetic) is rare. Redo-sternotomy for isolated tricuspid replacement is associated with higher risk. Efficacy and durability of transcatheter valve implantation for severe tricuspid stenosis is unclear. Case Summary Successful tricuspid valve-in-valve implantation (Edwards 26 mm Ultra) to exteriorize a retained, unextractable pacemaker lead causing very early surgical bioprosthetic valve dysfunction in a 66 -year-old Caucasian woman. The original indication for surgical replacement was pacemaker-lead-related severe tricuspid regurgitation. History of CABG and subsequent surgical replacement rendered risk of a third sternotomy and open-heart surgery prohibitive. Conclusion Successful reduction in severity of bioprosthetic tricuspid stenosis and improvement of right heart failure with transcatheter valve-in-valve implantation. Percutaneous tricuspid valve implantation could be considered an alternative to redo-sternotomy for severe bioprosthetic tricuspid stenosis.