Transjugular Tricuspid Valve-in-Valve Replacement

Weich, Hellmuth; Janson, Jacques; Wyk, Jacques van; Herbst, Philip; Roux, Pieter Le; Doubell, Anton

doi:10.1161/circulationaha.111.027342

Cited by 27 publications

(10 citation statements)

References 3 publications

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“…[41] reported the feasibility of off-pump transapical tricuspid valved stent implantation in an acute animal model, using a novel valved stent with a self-expandable, superabsorbent polymer to reduce paravalvular leakage. Beating-heart transcatheter tricuspid valve implantation to treat a degenerated bioprosthesis in tricuspid position through direct transatrial or transjugular access has been reported [42,43]. An alternative approach to percutaneous treatment of tricuspid valve is the implantation of separate valves in the superior vena cava and inferior vena cava to prevent damage to the liver and other organs [44].…”

Section: Interventional Cardiology Perspectivesmentioning

confidence: 99%

Management of tricuspid regurgitation

Bonis¹,

Taramasso²,

Lapenna³

et al. 2014

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Secondary tricuspid regurgitation is the most frequent type of tricuspid insufficiency in western countries. Its surgical treatment is still an object of debate both in terms of timing and surgical techniques. Until recently, the avoidance of surgery for tricuspid repair was commonly accepted in patients with less than severe secondary tricuspid regurgitation undergoing left-sided valve surgery. More recently, compelling evidence in favour of a more aggressive surgical approach in this setting has emerged. The surgical technique should be tailored to the stage of disease. Ring annuloplasty is more durable than suture annuloplasty and represents the method of choice in the presence of isolated annular dilatation. In patients in whom the dilatation of the tricuspid annulus is combined with significant leaflet tethering, annuloplasty alone is unlikely to be durable and additional procedures have been proposed in order to achieve a more durable repair. In this review, pathophysiology, surgical indications, techniques of repair and outcomes of secondary tricuspid regurgitation will be discussed. We will also focus on the challenging issue of significant tricuspid regurgitation occurring late after left-sided valve surgery. Finally, the current and future role of percutaneous tricuspid valve technologies will be briefly described.

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Section: Interventional Cardiology Perspectivesmentioning

confidence: 99%

Management of tricuspid regurgitation

Bonis¹,

Taramasso²,

Lapenna³

et al. 2014

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“…All valves were implanted via the femoral veins; however, successful valve delivery via a venous neck vessel has been described as well. 21,22 Seven patients were treated with a Melody valve, 5 with a Sapien XT 29 mm valve, and 4 with a Sapien 26-mm valve. Initially, only the Melody valve was available for treatment.…”

Section: Technical Considerationsmentioning

confidence: 99%

Percutaneous Tricuspid Valve Implantation

Eicken

Schubert

Hager

et al. 2015

Circ: Cardiovascular Interventions

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Background-Severe tricuspid valve (TV) dysfunction may lead to surgical TV replacement with a biological valve prosthesis in patients with congenital heart disease. To expand the lifetime of this valve and reduce the number of surgeries, percutaneous TV implantation (PTVI) may be an effective alternative to repeated surgery. We report on our 2-center experience with PTVI. Methods and Results-Between 2008 and 2014, 17 percutaneous valves were implanted in 16 patients with TV bioprosthesis dysfunction (9 females) from 2 centers. Median age and weight were 31.3 years (5-77.2) and 65.2 kg (17.7-107); 14 patients had congenital heart disease (univentricular heart with a right atrial to right ventricle bioprosthesis in 3, Ebstein's anomaly of the TV in 5, and other in 6), and 2 had acquired TV dysfunction. All procedures were successful (Melody n=7, Sapien 26 mm valve n=4, Sapien XT 29 mm valve n=6). One valve showed early dysfunction. It was replaced surgically and shortly after that a repeated PTVI was performed. The median duration of follow-up was 2.1 years (3 days to 6.3 years). The percutaneous valve was performing well in 15 of 16 patients. Conclusions-PTVI was safe and effectively improved TV function in all but 1 patient at midterm follow-up. We think that PTVI is a good alternative to repeated surgical TV replacements and that it may reduce the total number of open heart surgeries in these patients. (Circ Cardiovasc Interv. 2015;8:e002155.

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“…There are a couple of case reports describing alternative procedures, such as venous femoral transseptal mitral valve-in-valve implantation [43], or venous transjugular transseptal mitral valve-in-valve implantation [44]. The transjugular access has also been used to access the tricuspid valve [45]. Another alternative is the access through a right lateral thoracotomy and direct atrial access [46, 47], where both atria can be approached.…”

Section: Transatrial /Transjugular /Femoral Veinmentioning

confidence: 99%

Which way in? The Necessity of Multiple Approaches to Transcatheter Valve Therapy

Bleiziffer¹,

Krane²,

Deutsch³

et al. 2014

CCR

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TAVI (transcatheter aortic valve implantation) is a less invasive treatment of the stenotic aortic valve while avoiding midline sternotomy and cardiopulmonary bypass. A crimped biological valve on a self-expanding or balloon-expandable stent is inserted antegradely or retrogradely under fluoroscopy, and deployed on the beating heart. Among the worldwide TAVI programs, many different concepts have been established for the choice of the access site. Whether retrograde or antegrade TAVI should be considered the superior approach is matter of an ongoing debate. The published literature demonstrates safety of all techniques if performed within a dedicated multidisciplinary team. Since there is no data providing evidence if one approach is superior to another, we conclude that an individualized patient-centered decision making process is most beneficial, taking advantage of the complementarity of the different access options. The aim of this article is to give an overview of the current practice of access techniques for transcatheter based valve treatment and to outline the respective special characteristics.

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Transjugular Tricuspid Valve-in-Valve Replacement

Cited by 27 publications

References 3 publications

Management of tricuspid regurgitation

Management of tricuspid regurgitation

Percutaneous Tricuspid Valve Implantation

Which way in? The Necessity of Multiple Approaches to Transcatheter Valve Therapy

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