Transcatheter tricuspid valve replacement
In patients who have undergone prior tricuspid valve replacement with a bioprosthetic valve (BPV) or tissue valve, eventual valve failure is inevitable. For high-risk operative patients, transcatheter tricuspid valve-in-valve (TVIV) replacement is now becoming a common intervention with either the Medtronic Melody™ transcatheter pulmonary valve or the Edwards SAPIEN™ Transcatheter Heart Valve (THV).[56]Tzifa A, Momenah T, Al Sahari A, et al. Transcatheter valve-in-valve implantation in the tricuspid position. EuroIntervention. 2014 Dec;10(8):995-9.
http://www.ncbi.nlm.nih.gov/pubmed/24755248?tool=bestpractice.com
[57]Hoendermis ES, Douglas YL, van den Heuvel AF. Percutaneous Edwards SAPIEN valve implantation in the tricuspid position: case report and review of literature. EuroIntervention. 2012 Sep;8(5):628-33.
http://www.ncbi.nlm.nih.gov/pubmed/22995090?tool=bestpractice.com
[58]Sorajja P, Whisenant B, Hamid N, et al. Transcatheter repair for patients with tricuspid regurgitation. N Engl J Med. 2023 May 18;388(20):1833-42.
https://www.doi.org/10.1056/NEJMoa2300525
http://www.ncbi.nlm.nih.gov/pubmed/36876753?tool=bestpractice.com
[59]Sala A, Hahn RT, Kodali SK, et al. Tricuspid valve regurgitation: current understanding and novel treatment options. J Soc Cardiovasc Angiogr Interv. 2023 Sep-Oct;2(5):101041.
https://www.doi.org/10.1016/j.jscai.2023.101041
http://www.ncbi.nlm.nih.gov/pubmed/39132395?tool=bestpractice.com
More trials are underway that will help to evaluate the effects of transcatheter TV therapies on clinical outcomes.[36]Davidson LJ, Tang GHL, Ho EC, et al. The tricuspid valve: a review of pathology, imaging, and current treatment options: a scientific statement from the American Heart Association. Circulation. 2024 May 28;149(22):e1223-38.
https://www.doi.org/10.1161/CIR.0000000000001232
http://www.ncbi.nlm.nih.gov/pubmed/38660790?tool=bestpractice.com
The framework of the previously placed BPV provides a landing zone for the transcatheter valve, which allows the interventional cardiologist to implant a new functional valve within the orifice of the old dysfunctional valve with a much lower risk than if a redo sternotomy and cardiopulmonary bypass were required.[60]Cullen MW, Cabalka AK, Alli OO, et al. Transvenous, antegrade Melody valve-in-valve implantation for bioprosthetic mitral and tricuspid valve dysfunction: a case series in children and adults. JACC Cardiovasc Interv. 2013 Jun;6(6):598-605.
http://www.ncbi.nlm.nih.gov/pubmed/23683739?tool=bestpractice.com
[61]Roberts PA, Boudjemline Y, Cheatham JP, et al. Percutaneous tricuspid valve replacement in congenital and acquired heart disease. J Am Coll Cardiol. 2011 Jul 5;58(2):117-22.
http://www.onlinejacc.org/content/58/2/117
http://www.ncbi.nlm.nih.gov/pubmed/21718905?tool=bestpractice.com