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Orthotopic Transcatheter Tricuspid Valve Replacement After Heterotopic Caval Valve Failure
Matteo Biroli1, Cong Lu2, Cristina Ferrari1
1Centro Cardiologico Monzino IRCCS, Milan, Italy.
Background:
Heterotopic caval valve implantation has emerged as a compassionate transcatheter option for patients with severe tricuspid regurgitation (TR) deemed unsuitable for edge-to-edge repair. However, long-term durability and management of device failure remain poorly defined.
Case Summary:
We report the case of a 70-year-old woman with prior heterotopic TricValve implantation because of massive TR, who presented with recurrent right-sided heart failure secondary to inferior vena cava prosthetic dysfunction. Multimodality imaging revealed the known significant TR and severe degeneration of the heterotopic valve at the inferior vena cava position, and confirmed anatomical suitability for orthotopic transcatheter tricuspid valve replacement (TTVR). The patient subsequently underwent successful Evoque TTVR, achieving complete TR abolition and TricValve unloading.
Discussion And Take-Home Messages:
This case highlights the versatility of TTVR as a comprehensive solution for clinically significant TR. Guided by advanced multimodality imaging, Evoque TTVR effectively provided definitive TR correction without any device interaction in a complex anatomical setting.
