Clinical Experience of Transcatheter Tricuspid Valve-In-Ring Interventions With Incomplete Rings: Transjugular and...

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Tricuspid valve-in-ring procedures are emerging as an option for patients with degenerated tricuspid valve annuloplasty rings.
• Transcatheter valve replacement techniques are advancing, offering less invasive options for structural heart disease.

Purpose of the Study:

• To evaluate the feasibility and outcomes of tricuspid valve-in-ring implantation using balloon-expandable valves.
• To compare the transjugular and transfemoral access routes for this procedure.

Main Methods:

• A small single-center series involving patients undergoing tricuspid valve-in-ring implantation.
• Utilized balloon-expandable valves via both transjugular and transfemoral approaches.
• Assessed procedural success, access-site complications, and paravalvular leak rates.

Main Results:

• Procedural success was higher with the transjugular approach (86%) versus transfemoral (60%).
• Transjugular access had no access-site complications, while transfemoral had a 20% groin complication rate.
• Paravalvular leak rates were lower with transjugular (29%) compared to transfemoral access (60%).
• Paravalvular leak varied by ring type, being most frequent with rigid rings and lowest with flexible bands.

Conclusions:

• Tricuspid valve-in-ring implantation is feasible via both transjugular and transfemoral routes.
• The transjugular approach appears superior regarding procedural success, access-site complications, and paravalvular leak.
• Ring characteristics influence paravalvular leak, suggesting careful device selection is crucial.