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Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
Published on: February 11, 2022
Cross-Organ Recovery After Transcatheter Tricuspid Valve Replacement With Diuretic and Antiviral Discontinuation:
Adham Sameer A Bardeesi1, Aiman Ghrab2, Julien Ternacle3
1Medical-Surgical Unit for Valvular Heart Disease, Department of Cardiology and Cardiovascular Surgery, Haut-Lévêque Cardiology Hospital, Bordeaux University Hospital (CHU), Pessac, France; Department of Cardiac Surgery, King Fahad Specialist Hospital Damman, Saud Al-Babtain Cardiac Center, Dammam, Saudi Arabia.
Background:
Transcatheter tricuspid valve replacement (TTVR) is an emerging option for patients with severe tricuspid regurgitation (TR) at prohibitive surgical risk. Severe TR is associated with systemic venous congestion, multiorgan dysfunction, and high mortality, yet isolated tricuspid surgery is rarely performed.
Case Summary:
A 68-year-old woman with prior double mechanical valve replacement, chronic kidney disease, and hepatitis B, treated with entecavir, presented with dyspnea and edema. Imaging revealed torrential TR with a 43-mm annulus. Because of high surgical risk, she underwent successful TTVR. TR abolition allowed cessation of diuretics and antiviral therapy after normalization of hepatic tests and viral load.
Discussion:
This case illustrates how TTVR-mediated venous decongestion can reverse renal and hepatic alterations and enable cessation of supportive therapies.
Take-Home Messages:
TTVR can abolish TR, improve right-heart hemodynamics, and provide systemic benefits beyond cardiac function. Venous decongestion may enable cross-organ recovery and allow withdrawal of diuretics and antiviral therapy.
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