Minimally invasive tricuspid valve surgery after failed transcatheter tricuspid valve repair

Q: What is the clinical evidence from this study?

Study design: Case Report. Population: Severe tricuspid regurgitation after failed transcatheter tricuspid valve repair (n=2). Intervention: Minimally invasive tricuspid valve surgery (valve replacement).

Serdar Akansel; Markus Kofler; Martina Dini; Stephan Jacobs; V Falk; Jörg Kempfert

doi:10.21037/acs-2025-aw-53-tvd

March 1, 2026Annals of Cardiothoracic SurgeryOpen Access

Minimally invasive tricuspid valve surgery after failed transcatheter tricuspid valve repair

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Key result

Minimally invasive tricuspid valve replacement shows early success after failed transcatheter repair.

n=2

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Key Points

To describe surgical techniques and clinical outcomes for device explantation and minimally invasive tricuspid valve replacement following failed transcatheter repair.
Evaluated two patients (N=2) presenting with symptomatic severe tricuspid regurgitation after failed transcatheter edge-to-edge repair (TriClip) or annuloplasty (Cardioband).
Conducted minimally invasive surgery through a right anterolateral minithoracotomy using three-dimensional endoscopic visualization and femoral cardiopulmonary bypass.
Explanted the failed devices using tailored methods, including a cut-and-unscrew technique for Cardioband anchors, followed by bioprosthetic valve replacement.
In Case 1, three TriClips were explanted and a 33-mm St. Jude Epic bioprosthesis was implanted without paravalvular leak, followed by permanent pacemaker implantation for third-degree atrioventricular block before discharge.
In Case 2, an endothelialized Cardioband device was successfully removed using the cut-and-unscrew technique and replaced with a bioprosthesis, requiring rethoracotomy for bleeding on postoperative day 1 before intensive care discharge on day 7.

Study Design

Type

Case Report (n=2)

Multicenter

No

Structured PICO

P

Population

Patient with failed transcatheter tricuspid valve repair (TriClip) presenting with loss of insertion and a large coaptation gap

I

Intervention

Minimally invasive tricuspid valve replacement using a 33-mm St. Jude Epic bioprosthesis, following explantation of failed TriClip devices and excision of valve leaflets

O

Outcome

Perioperative transesophageal echocardiography (TEE) findings (text truncated)

Limitations

Only two cases are presented, meaning findings cannot be generalized to the broader population and require confirmation in larger cohorts.

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Implication

Minimally invasive tricuspid valve replacement is a feasible surgical option for managing failed transcatheter tricuspid valve edge-to-edge repair.

Abstract

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Cite This Study

Akansel et al. (2026) conducted a case report in Severe tricuspid regurgitation after failed transcatheter tricuspid valve repair (n=2). Minimally invasive tricuspid valve surgery (valve replacement) was evaluated. Minimally invasive tricuspid valve replacement after failed transcatheter repair was successfully performed in two high-risk patients, resulting in good echocardiographic outcomes and discharge within 7 days.

synapsesocial.com/papers/6a025e8493868c48f3093d8f https://doi.org/10.21037/acs-2025-aw-53-tvd

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Minimally invasive tricuspid valve surgery after failed transcatheter tricuspid valve repair

Figures

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Minimally invasive tricuspid valve surgery after failed transcatheter tricuspid valve repair

Figures

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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