• Roberto Scarsini, Mattia Lunardi, Gabriele Pesarini, Fausto Castriota, Mauro Feola, Valeria Ferrero, Giuseppe Faggian, Corrado Vassanelli, and Flavio Ribichini.
• Division of Cardiology, Department of Medicine, University of Verona, Italy.
• Int. J. Cardiol. 2017 May 15; 235: 141-146.

BackgroundTranscatheter tricuspid VIV replacement has been proposed as a feasible option for high-risk patients with previous tricuspid valve replacement that undergo valve degeneration causing refractory heart failure. However, little is known about the long-term outcome of patients treated with transcatheter tricuspid VIV. We evaluate the safety of transcatheter tricuspid valve-in-valve (VIV) replacement by using balloon-expandable aortic valve stents and the long-term follow-up.Methods And ResultsFrom January 2013 to March 2016, 4 patients underwent transcatheter tricuspid VIV in our center using balloon-expandable Edwards Sapien-XT and Sapien-3 valves. In all cases the procedure succeeded with significant improvement of the tricuspid valve area (from 0.98±0.29cm2 to 3.1±0.45cm2, p=0.005), right atrial pressure (from 21±7.78mmHg to 8.5±2.51mmHg, p=0.025) and mean trans-valvular gradient (from 11.5±4mmHg to 3.32±1.28mmHg, p=0.02). Three out of 4 patients presented a follow up longer than 2.5years. At median follow up of 32months (range 9-47months) all patients were alive and presented with NYHA class I-II. Only one patient, who presented impaired right ventricular function at baseline, experienced re-hospitalization during the follow-up time. Echocardiographic assessment at long-term disclosed a well-maintained hemodynamic performance with low trans-valvular gradients and no significant valvular regurgitation in all cases.ConclusionsIn our experience, trans-catheter tricuspid VIV demonstrated good long-term results in terms of valve performance and functional class improvement at 32months from intervention.Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

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