Tricuspid Structural Valve Deterioration Treated with a Transcatheter Valve-in-Valve Implantation: A Single-Center Prospective Registry

Nili Schamroth Pravda, Hana Vaknin Assa, Amos Levi, Guy Witberg, Yaron Shapira, Mordechai Vaturi, Katia Orvin, Yeela Talmor Barkan, Ashraf Hamdan, Raffael Mishaev, Ram Sharoni, Leor Perl, Alexander Sagie, Ran Kornowski, Pablo Codner

Research output: Contribution to journalArticlepeer-review

Abstract

The valve-in-valve (ViV) technique is an emerging alternative for the treatment of bioprosthetic structural valve deterioration (SVD) in the tricuspid position. We report on the outcomes of patients treated by a transcatheter tricuspid valve-in-valve (TT-ViV) implantation for symptomatic SVD in the tricuspid position during the years 2010–2019 at our center. Three main outcomes were examined during the follow-up period: TT-ViV hemodynamic data per echocardiography, mortality and NYHA functional class. Our cohort consisted of 12 patients with a mean age 65.4 ± 11.9 years, 83.3% male. The mean time from initial valve intervention to TT-ViV was 17.4 ± 8.7 years. The indications for TT-ViV were varied (41.7% for predominant regurgitation, 33.3% for predominant stenosis and 25.0% with a mixed pathology). All patients were treated with a balloon-expandable device. The mean follow-up was 3.4 ± 1.3 years. Tricuspid regurgitation was ≥ moderate in 57.2% of patients prior to the procedure and this decreased to 0% following the procedure. The mean transtricuspid valve gradients mildly decreased from the mean pre-procedural values of 9.0 mmHg to 7.0 mmHg at one month following the procedure (p = 0.36). Mortality at one year was 8.0% (95% CI 0–23). At the baseline, 4 patients (33.3%) were in NYHA functional class III/IV; this was reduced to 2 patients (18.2%) at the one year follow-up and both were in NYHA III. The TT-ViV procedure offered a safe, feasible and less invasive treatment option for patients with SVD in our detailed cohort.

Original languageEnglish
Article number2667
JournalJournal of Clinical Medicine
Volume11
Issue number9
DOIs
StatePublished - 1 May 2022

Keywords

  • outcomes
  • structural valve deterioration
  • transcatheter
  • tricuspid valve
  • valve-in-valve

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