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Published on: December 11, 2017
The "Spider and the Fly" Technique for Transcatheter Tricuspid Valve Replacement in Failed Edge-to-Edge Repair
Marco Gennari1, Cristina Ferrari1, Fabio Fazzari2
1Department of Invasive Cardiology, Structural and Valvular Interventional Cardiology Unit, IRCCS Centro Cardiologico Monzino, Milan, Italy.
Background:
Failed tricuspid edge-to-edge repair with recurrent symptoms poses a challenge for optimal management. We report the first case successfully treated with transcatheter tricuspid valve replacement using the EVOQUE system after transcatheter electrosurgery laceration of the septal leaflet.
Case Presentation:
A 75-year-old woman was referred for recurrent severe tricuspid regurgitation after failed edge-to-edge repair due to early septal leaflet laceration after positioning of 2 devices. The heart team approved a percutaneous approach with advanced transcatheter techniques.
Discussion:
The electrosurgical laceration and stabilization of clip is a known tool to treat failed mitral repairs. This is the first report of a similar technique to treat recurrent tricuspid insufficiency after tricuspid edge-to-edge repair.
Conclusions:
After failed tricuspid edge-to-edge repair, transcatheter electrosurgery can split the leaflet from the clip and allow effective implantation of a dedicated tricuspid valve replacement device.
