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Transcatheter Tricuspid Valve Replacement for Recurrent Tricuspid Regurgitation After Tricuspid Transcatheter
Denizhan Ozdemir1, Jair Basantes de la Calle1, Dhairya Patel1
1Cedars-Sinai Medical Center, Los Angeles, California, USA.
Background:
It is currently unknown whether tricuspid valve replacement with EVOQUE is feasible after tricuspid transcatheter edge-to-edge repair.
Case Summary:
An 81-year-old patient with a complex history of multivalvular heart disease, previously treated with surgical and catheter approaches, presented to our center with symptomatic recurrent tricuspid regurgitation despite maximally tolerated medical therapy and previous tricuspid transcatheter edge-to-edge repair (T-TEER) with 2 TriClips. A multidisciplinary heart team determined that patient was high-risk for tricuspid surgery due to age, comorbidities, and previous sternotomy. Multimodality imaging revealed no anatomical contraindications for transcatheter tricuspid valve replacement (TTVR); however, due to the patient's history of appropriate antitachycardia therapies, implantable cardioverter-defibrillator lead removal and leadless pacemaker implantation were performed, enabling safe and successful transcatheter tricuspid valve replacement in the presence of the prior T-TEER device.
Discussion:
Although limited to individual case reports, TTVR with EVOQUE may be feasible for select patients at experienced centers.
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