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Transcatheter tricuspid valve-in-valve implantation with bioprosthetic balloon expandable valve

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Abstract

Objectives

This study was conducted to evaluate the outcome of the transcatheter valve-in-valve implantation for degenerated tricuspid bioprosthetic valves with transcatheter aortic valves.

Methods

This retrospective study enrolled all consecutive patients who were considered high risk for reoperations by the heart team and who underwent transcatheter valve-in-valve implantation for degenerated tricuspid bioprosthetic valves in Tehran Heart Center, Tehran, Iran. All the procedures were performed via the transfemoral venous route under echocardiography and fluoroscopy guidance with Edwards SAPIEN transcatheter heart valves (Edwards Lifesciences, Irvine, CA).

Results

Ten patients underwent successful transcatheter valve-in-valve implantation in the tricuspid position without any major complications or need for emergency surgical interventions. The mean age was 54.1 ± 17.1 years, and 8 patients were female. The median follow-up was 19.5 months (16–32.25 mon). The mean period between the last tricuspid valve replacement and transcatheter valve-in-valve implantation was 4.9 ± 2.2 years. The bioprosthetic valves were Hancock in three patients, Mosaic in the other three patients, and Biocor, Pericarbon, Perimount, and Epic in the other patients. After the procedure, the clinical and functional status improved significantly in all the patients. The mean transvalvular gradient decreased from 6.75 ± 2.66 mm Hg to 2.85 ± 0.89 (P < 0.001), and the postoperative tricuspid regurgitation severity decreased significantly in almost all the patients. The hospitalization period after the procedure was 4.4 ± 1.7 days.

Conclusions

In high-risk patients, transcatheter valve-in-valve implantation seems to be a safe and minimally invasive alternative to reoperations for degenerated tricuspid bioprosthetic valves.

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Authors and Affiliations

  1. Interventional Cardiology, Head of the Endovascular and Structural Heart Intervention Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran

    Ali-Mohammad Haji-Zeinali & Nasrin Etesamifard

  2. Department of Cardiology, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran

    Zohre Mohammadi

  3. Research Department, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran

    Mohammad-Mohsen Haji-Zeinali

  4. Department of Echocardiography, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran

    Mohammad Sahebjam

  5. Department of Cardiac Surgery, Tehran Heart Center, Tehran University of Medical Sciences, Tehran, Iran

    Kiomars Abbasi

Authors
  1. Ali-Mohammad Haji-Zeinali
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  2. Nasrin Etesamifard
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  3. Zohre Mohammadi
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  4. Mohammad-Mohsen Haji-Zeinali
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  5. Mohammad Sahebjam
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Correspondence to Ali-Mohammad Haji-Zeinali.

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Conflict of interest

Ali-Mohammad Haji-Zeinali has no relevant financial or non-financial interests to disclose. Nasrin Etesamifard has no relevant financial or non-financial interests to disclose. Zohre Mohammadi has no relevant financial or non-financial interests to disclose. Mohammad-Mohsen Haji-Zeinali has no relevant financial or non-financial interests to disclose. Mohammad Sahebjam has no relevant financial or non-financial interests to disclose. Kiomars Abbasi has no relevant financial or non-financial interests to disclose.

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Haji-Zeinali, AM., Etesamifard, N., Mohammadi, Z. et al. Transcatheter tricuspid valve-in-valve implantation with bioprosthetic balloon expandable valve. Gen Thorac Cardiovasc Surg 70, 947–953 (2022). https://doi.org/10.1007/s11748-022-01829-z

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  • DOI: https://doi.org/10.1007/s11748-022-01829-z

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