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Successful Transcatheter Tricuspid Valve Replacement 30 Years After Heart Transplantation
Mateusz Orzalkiewicz1, Tullio Palmerini1, Elena Biagini2
1Interventional Cardiology Unit, IRCCS University Hospital of Bologna, Policlinico S. Orsola, Bologna, Italy.
Background:
Tricuspid regurgitation (TR) is the most common valvular complication after orthotopic heart transplantation (HTx), but its management is challenging.
Case Summary:
A 70-year-old woman presented with severe symptomatic iatrogenic TR due to chordal rupture and flail septal leaflet 30 years after HTx. The heart team opted for transcatheter tricuspid valve replacement (TTVR), and a 44-mm Evoque valve (Edwards Lifesciences) was implanted without complications. The patient's symptoms improved, with reduced diuretic dose and echocardiography showing a well-functioning prosthesis.
Discussion:
TTVR represents a novel therapy for patients with severe symptomatic TR. We present to our knowledge the first device success of TTVR in an HTx recipient, suggesting that TTVR is a viable option in these patients, who often present contraindications for redo cardiac surgery and transcatheter edge-to-edge repair.
Take-Home Messages:
Severe TR is a common complication after HTx, and high-risk surgery is rarely performed. Various transcatheter treatment options are available, but TTVR could become the treatment of choice pending more studies.
