Bioprosthetic tricuspid valve stenosis in end-stage renal failure

Outcome of bioprosthetic valve replacement in the tricuspid position in patients with kidney failure is unknown. The authors describe a case of accelerated bioprosthetic tricuspid valve calcification leading to critical stenosis in a patient on chronic dialysis and with poorly controlled hyperparathyroidism. He required a second valve replacement in less than 3 years from the initial tricuspid replacement surgery. Both renal failure and its associated hyperparathyroidism have been implicated in native heart valve calcification. This case suggests that bioprosthetic valves could also be at risk for rapid calcification; more frequent monitoring of prosthetic valve function may be necessary.