Concomitant Transcatheter Aortic and Tricuspid Valve Replacement
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Updated: Nov 2, 2026

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Published on: January 20, 2022
Jaiel Niamat1, Claire Ren1, Lucas Uchoa De Assis1
1Department of Cardiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
Background:
Severe tricuspid regurgitation (TR) after transcatheter aortic valve replacement (TAVR) is associated with adverse outcomes.
Case Summary:
A 65-year-old man with advanced right heart failure symptoms and torrential TR was accepted for transcatheter tricuspid valve replacement (TTVR). After an unforeseen treatment delay, reassessment demonstrated progression of concomitant mild-to-moderate aortic stenosis (AS) to severe AS. He underwent successful TAVR and TTVR during 1 procedure with an excellent clinical outcome.
Discussion:
Given the sequence of disease progression with symptomatic torrential TR preceding the development of severe AS, an indication for TAVR and TTVR was established. A single-procedure strategy was favored over a staged approach based on the assumption that TAVR alone could increase forward flow and right-sided loading conditions, potentially worsening right heart failure.
Take-Home Messages:
Concomitant TAVR and TTVR may benefit selected patients. Pre-TAVR identification of patients requiring adjunctive TTVR and determination of the optimal timing (concomitant or staged) remain challenging.
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