Background Transcatheter tricuspid VIV replacement has been proposed as a feasible option for high-risk patients with previous tricuspid valve replacement that undergo valve degeneration causing refractory heart failure. However, little is known about the long-term outcome of patients treated with transcatheter tricuspid VIV. We evaluate the safety of transcatheter tricuspid valve-in-valve (VIV) replacement by using balloon–expandable aortic valve stents and the long-term follow-up. Methods and results From January 2013 to March 2016, 4 patients underwent transcatheter tricuspid VIV in our center using balloon-expandable Edwards Sapien-XT and Sapien-3 valves. In all cases the procedure succeeded with significant improvement of the tricuspid valve area (from 0.98 ± 0.29 cm2 to 3.1 ± 0.45 cm2, p = 0.005), right atrial pressure (from 21 ± 7.78 mmHg to 8.5 ± 2.51 mmHg, p = 0.025) and mean trans-valvular gradient (from 11.5 ± 4 mmHg to 3.32 ± 1.28 mmHg, p = 0.02). Three out of 4 patients presented a follow up longer than 2.5 years. At median follow up of 32 months (range 9–47 months) all patients were alive and presented with NYHA class I-II. Only one patient, who presented impaired right ventricular function at baseline, experienced re-hospitalization during the follow-up time. Echocardiographic assessment at long-term disclosed a well-maintained hemodynamic performance with low trans-valvular gradients and no significant valvular regurgitation in all cases. Conclusions In our experience, trans-catheter tricuspid VIV demonstrated good long-term results in terms of valve performance and functional class improvement at 32 months from intervention.

Long-term follow-up after trans-catheter tricuspid valve-in-valve replacement with balloon-expandable aortic valves

Scarsini, Roberto;Lunardi, Mattia;PESARINI, Gabriele;FAGGIAN, Giuseppe;VASSANELLI, Corrado;RIBICHINI, Flavio Luciano
2017-01-01

Abstract

Background Transcatheter tricuspid VIV replacement has been proposed as a feasible option for high-risk patients with previous tricuspid valve replacement that undergo valve degeneration causing refractory heart failure. However, little is known about the long-term outcome of patients treated with transcatheter tricuspid VIV. We evaluate the safety of transcatheter tricuspid valve-in-valve (VIV) replacement by using balloon–expandable aortic valve stents and the long-term follow-up. Methods and results From January 2013 to March 2016, 4 patients underwent transcatheter tricuspid VIV in our center using balloon-expandable Edwards Sapien-XT and Sapien-3 valves. In all cases the procedure succeeded with significant improvement of the tricuspid valve area (from 0.98 ± 0.29 cm2 to 3.1 ± 0.45 cm2, p = 0.005), right atrial pressure (from 21 ± 7.78 mmHg to 8.5 ± 2.51 mmHg, p = 0.025) and mean trans-valvular gradient (from 11.5 ± 4 mmHg to 3.32 ± 1.28 mmHg, p = 0.02). Three out of 4 patients presented a follow up longer than 2.5 years. At median follow up of 32 months (range 9–47 months) all patients were alive and presented with NYHA class I-II. Only one patient, who presented impaired right ventricular function at baseline, experienced re-hospitalization during the follow-up time. Echocardiographic assessment at long-term disclosed a well-maintained hemodynamic performance with low trans-valvular gradients and no significant valvular regurgitation in all cases. Conclusions In our experience, trans-catheter tricuspid VIV demonstrated good long-term results in terms of valve performance and functional class improvement at 32 months from intervention.
2017
Structural heart interventions
Trans-catheter tricuspid valve replacement
Tricuspid valve
Valve-in-valve
Adult
Aged
Cardiac Catheterization
Echocardiography
Female
Follow-Up Studies
Heart Valve Diseases
Heart Valve Prosthesis
Hemodynamics
Humans
Male
Middle Aged
Prosthesis Design
Treatment Outcome
Heart Valve Prosthesis Implantation
Long Term Adverse Effects
Reoperation
Tricuspid Valve
Structural heart interventions; Trans-catheter tricuspid valve replacement; Tricuspid valve; Valve-in-valve
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11562/961805
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