Key result
Percutaneous double balloon valvuloplasty increased valve area (0.65 to 1.15 cm2 and 0.9 to 1.65 cm2) in 2 patients, but both required valve replacement at 14 and 21 months.
Why the study?
Does percutaneous double balloon valvuloplasty improve hemodynamics in patients with stenosis of porcine bioprostheses in the tricuspid valve position?
Case Report (n=2)
Does percutaneous double balloon valvuloplasty improve hemodynamics in patients with stenosis of porcine bioprostheses in the tricuspid valve position?
Percutaneous double balloon valvuloplasty for tricuspid bioprosthesis stenosis provides immediate hemodynamic improvement but is palliative, as restenosis and the need for valve replacement occur at midterm follow-up.
May offer palliative relief in tricuspid bioprosthetic stenosis; leaves open durability versus surgery in larger cohorts.
The feasibility and results of percutaneous double balloon valvuloplasty were evaluated in 2 patients with stenosis of porcine bioprostheses in the tricuspid valve position. The procedures were performed with a Trefoil 3 x 10 and a 15 mm balloon. Long inflations (4 and 3 minutes) were well tolerated. A significant immediate increase in the valve area, without significant valvular regurgitation, was achieved in both cases, from 0.65 to 1.15 cm2 in case 1 and from 0.9 to 1.65 cm2 in case 2. Both patients required valve replacement during the follow-up, at 14 and 21 months. There was no restenosis, but echocardiography showed right atrial thrombosis in case 1. Progressive restenosis with peripheral edema and increase of the mean doppler gradient occurred in case 2. The procedure is feasible, safe, and well tolerated. It provides significant immediate hemodynamic improvement, but it should be considered as a palliative technique since a normal valve area can not usually be obtained and a restenosis is likely to occur at midterm follow-up.
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Slama et al. (1993) conducted a case report in Stenosis of porcine bioprostheses in the tricuspid valve position (n=2). Percutaneous double balloon valvuloplasty was evaluated on Valve area increase and clinical follow-up. Percutaneous double balloon valvuloplasty increased valve area (0.65 to 1.15 cm2 and 0.9 to 1.65 cm2) in 2 patients, but both required valve replacement at 14 and 21 months.
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