Key result
Concomitant single-procedure TAVR and TTVR achieves successful clinical outcome for severe AS and TR.
Why the study?
Severe TR after TAVR is associated with adverse outcomes, and identifying patients who need adjunctive TTVR as well as determining the optimal concomitant versus staged timing remain challenging.
Case Report (n=1)
Concomitant TAVR and TTVR in a single procedure can achieve an excellent clinical outcome in selected patients with severe aortic stenosis and torrential tricuspid regurgitation, potentially avoiding the worsening of right heart failure that might occur with TAVR alone.
Answers are grounded in this paper and cite their sources.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
““Concomitant transcatheter aortic and tricuspid valve replacement in one procedure is feasible and may benefit selected patients. Further research is needed to better identify patients requiring adjunctive TTVR after TAVR and to determine the optimal timing (concomitant vs. staged).””
Combined TAVR and TTVR may be feasible in select cases; leaves open the need for prospective data on timing and outcomes.
Background Severe tricuspid regurgitation (TR) after transcatheter aortic valve replacement (TAVR) is associated with adverse outcomes. Case Summary A 65-year-old man with advanced right heart failure symptoms and torrential TR was accepted for transcatheter tricuspid valve replacement (TTVR). After an unforeseen treatment delay, reassessment demonstrated progression of concomitant mild-to-moderate aortic stenosis (AS) to severe AS. He underwent successful TAVR and TTVR during 1 procedure with an excellent clinical outcome. Discussion Given the sequence of disease progression with symptomatic torrential TR preceding the development of severe AS, an indication for TAVR and TTVR was established. A single-procedure strategy was favored over a staged approach based on the assumption that TAVR alone could increase forward flow and right-sided loading conditions, potentially worsening right heart failure. Take-Home Messages Concomitant TAVR and TTVR may benefit selected patients. Pre-TAVR identification of patients requiring adjunctive TTVR and determination of the optimal timing (concomitant or staged) remain challenging.
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Niamat et al. (2026) conducted a case report in Severe aortic stenosis and torrential tricuspid regurgitation with advanced right heart failure (n=1). Concomitant transcatheter aortic valve replacement (TAVR) and transcatheter tricuspid valve replacement (TTVR) was evaluated on Procedural success and clinical outcome. Concomitant TAVR and TTVR during 1 procedure achieved an excellent clinical outcome in 1 65-year-old man with severe aortic stenosis and torrential tricuspid regurgitation.
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