• Catheter Cardiovasc Interv · Nov 2016

    Percutaneous Transcatheter Treatment for Tricuspid Bioprosthesis Failure.

    • Neil Ruparelia, Antonio Mangieri, Marco Ancona, Francesco Giannini, Eustachio Agricola, Matteo Montorfano, Michele De Bonis, Ottavio Alfieri, Antonio Colombo, and Azeem Latib.
    • Department of Interventional Cardiology, San Raffaele Scientific Institute, Milan, Italy.
    • Catheter Cardiovasc Interv. 2016 Nov 15; 88 (6): 994-1001.

    ObjectivesTo report procedural and 30-day outcomes following percutaneous transcatheter valve-in-valve (VIV) implantation for tricuspid bioprosthesis failure, with a new generation balloon-expandable transcatheter aortic valve implantation prosthesis.BackgroundSevere tricuspid regurgitation is associated with a reduction in survival and increased morbidity. Many patients previously treated with tricuspid valve replacement require further intervention due to bioprosthesis failure. Surgical redo is the "gold standard" treatment however this is technically challenging and associated with significant risk. Percutaneous VIV intervention that is now well established in the management of aortic and mitral bioprosthesis failure may therefore be an alternative treatment option.MethodsThe study population consisted of all patients that underwent percutaneous transcatheter tricuspid VIV implantation for tricuspid bioprosthesis failure at the San Raffaele Scientific Institute, Milan, Italy.ResultsFive patients underwent successful transfemoral transcatheter tricuspid VIV implantation for bioprosthetic failure. One patient suffered acute kidney injury that was successfully medically managed. The remaining patients suffered no complications prior to hospital discharge. During 30-day follow-up, all patients reported a significant improvement in their functional status with normal valve function. Additionally, we observed an improvement in renal function (eGFR baseline 62.0 ± 16.5 vs. follow-up 70.2 ± 23.1 ml/min/m2 , P = 0.12) and improved hepatic congestion: bilirubin (1.47 ± 0.8 vs. 1.01 ± 0.7 mg/DL, P = 0.12), alanine aminotransferase (31.0 ± 11.1 vs. 23.2 ± 5.1 U/L, P = 0.11) and aspartate aminotransferase (35.8 ± 6.3 vs. 29.8 ± 13.6 U/L, P = 0.12).ConclusionsTransfemoral, transcatheter VIV treatment with a new generation balloon expandable devices appears to be a safe and efficacious treatment option for tricuspid bioprosthesis failure. © 2016 Wiley Periodicals, Inc.© 2016 Wiley Periodicals, Inc.

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