Right Ventricular Volume Unload: Transcatheter Tricuspid Valve Replacement in Congenital Heart Disease

The population of adults with repaired congenital heart disease is increasing, and given their frequent history of repeated surgeries, they are the ones that may benefit the most from less-invasive therapeutic options, in order to truly address their disease with a lifespan-management perspective. Tetralogy of Fallot patients frequently present with significant tricuspid regurgitation which has been associated with adverse clinical events.

We report hereinafter on a successful transcatheter tricuspid valve replacement (TTVR) in a middle-age Tetralogy of Fallot patient at high surgical risk. Our aim is to emphasize on the technical challenges but also on the major benefits of the procedure, either from a symptomatic or structural remodeling standpoint.

TTVR represents a promising therapy for this underserved subgroup of patients.

TTVR in Tetralogy of Fallot patients is feasible. Despite the frequent advanced and chronic right ventricular adverse remodeling observed in this population, those patients may derive a great benefit from the procedure. Right ventricular reverse remodeling was associated with major symptomatic and functional improvement.