Key result
Totally endoscopic beating-heart redo tricuspid replacement is feasible with normal valve function at 6 months.
Why the study?
Redo tricuspid surgery for bioprosthetic degeneration carries substantial risk after sternotomy, totally endoscopic experience remains limited, and preserving a well-incorporated bioprosthetic frame may avoid extensive annular dissection.
Case Report (n=1)
No
Totally endoscopic beating-heart redo tricuspid valve replacement using a frame-preserving strategy is feasible and may reduce operative risks in selected patients with structural bioprosthetic degeneration.
Supports feasibility of frame-preserving endoscopic redo tricuspid replacement in one case; leaves open comparative safety versus sternotomy.
Background: Redo tricuspid valve surgery for structural bioprosthetic degeneration is technically challenging and carries substantial operative risk, particularly after previous sternotomy. Totally endoscopic approaches may reduce re-entry-related morbidity, but experience in redo tricuspid surgery remains limited. In selected cases, preserving a well-incorporated bioprosthetic frame may avoid extensive annular dissection. Case presentation: A 46-year-old man presented with progressive right-sided heart failure 11 years after tricuspid bioprosthetic valve replacement for infective endocarditis. Echocardiography showed severe intra-prosthetic regurgitation and stenosis with calcified, retracted leaflets. Transcatheter valve-in-valve therapy was considered but not selected because of the patient’s young age, durability concerns, limited availability, and cost. Totally endoscopic beating-heart redo tricuspid valve replacement was performed through a right mini-thoracotomy under peripheral cardiopulmonary bypass. The degenerated leaflets were excised, the sewing ring was preserved, and a 29-mm mechanical prosthesis was implanted onto the retained frame. Recovery was uneventful, and valve function was normal at 6 months. Conclusion: This frame-preserving, totally endoscopic approach is feasible in selected patients, although further experience is needed.
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Nguyen et al. (2026) conducted a case report in Structural degeneration of tricuspid bioprosthesis (n=1). Totally endoscopic beating-heart redo tricuspid valve replacement using a frame-preserving strategy was evaluated on Procedural feasibility and valve function at 6 months. Totally endoscopic beating-heart redo tricuspid valve replacement using a frame-preserving strategy was feasible, resulting in an uneventful recovery and normal mechanical valve function at 6 months.
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