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

*Corresponding author for this work

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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