Key result
Valve-in-valve transcatheter tricuspid valve replacement successfully improved severe tricuspid stenosis and symptoms in a high-risk patient with bioprosthetic valve degeneration.
Why the study?
Current literature on valve-in-valve transcatheter tricuspid valve replacement is limited to case reports, and operator experience with this novel, off-label procedure remains limited.
Case Report (n=1)
No
Transcatheter aortic valve replacement can be feasibly used off-label for valve-in-valve tricuspid valve replacement in patients at prohibitive surgical risk.
Answers are grounded in this paper and cite their sources.
May inform high-risk tricuspid reintervention options; hypothesis-generating and requires prospective validation before practice change.
We report a novel use of transcatheter aortic valve replacement (TAVR) for valve-in-valve tricuspid valve replacement. A man in his 50s with prohibitive risks for surgical intervention underwent this procedure to improve severe, symptomatic tricuspid stenosis. Though current literature is limited to case reports, the Valve-in-Valve International Database (VIVID) reports similar mortality rates between surgical and transcutaneous replacement. As a novel, off-label procedure, there is limited operator experience. Nonetheless, in non-operative or high-risk patients, similar outcomes are noted in between transcatheter tricuspid valve replacement and surgical replacement. This registry sets the framework for further studies with the possibility of observing outcomes as operator experience increases, while highlighting the feasibility of the procedure.
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Budweg et al. (2022) conducted a case report in Bioprosthetic tricuspid valve degeneration with severe tricuspid stenosis (n=1). Valve-in-valve transcatheter tricuspid valve replacement (TTVR) was evaluated on Symptomatic improvement and echocardiographic flow gradients. Valve-in-valve transcatheter tricuspid valve replacement successfully improved severe tricuspid stenosis and symptoms in a high-risk patient with bioprosthetic valve degeneration.
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