Despite technical feasibility, percutaneous valve-in-valve implantation in the tricuspid position may be prone to early valve failure, raising concerns about its viability in some patients.
OBJECTIVE: To describe the cases of percutaneous valve failure following implantation of the Medtronic Melody™ and the Edwards Sapien™ valve in the tricuspid position. BACKGROUND: There have been recent reports of the use of percutaneously delivered valves to manage failing bioprosthetic tricuspid valves. Total patient numbers remain small and follow-up times are limited. METHODS: We describe four procedures in three patients from two centers where implantation of percutaneous valves within the scaffold of a bioprosthetic tricuspid valve was technically successful but there was early valve failure. RESULTS: In all cases, immediate results suggested excellent valve function; however, valve failure occurred early in three and later in one. Two patients elected for valve explantation and surgical placement of a further tricuspid valve. The third patient underwent a second percutaneous valve-in-valve procedure though this valve is also showing early signs of failure. CONCLUSIONS: Transcatheter placement of percutaneous valves in the tricuspid position is technically a relatively straightforward procedure but early valve failure raises some concerns about the viability of the valve in this position, at least in some patients.
Bentham et al. (Thu,) studied this question.
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