Transjugular transcatheter tricuspid valve replacement for persistent severe tricuspid regurgitation after transcatheter aortic valve replacement: a case report_West China Medical Journal

Authors：

PU Xingzhou , ZHAO Zhengang , WEI Xin , FENG Yuan ,  CHEN Fei ,  CHEN Mao

Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

CHEN Fei, Email: chenfeicardio@foxmail.com; CHEN Mao, Email: hmaochen@vip.sina.com

Keywords：

Tricuspid regurgitation; transcatheter tricuspid valve replacement; transcatheter aortic valve replacement

DOI：

10.7507/1002-0179.202407266

Video：

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This article reports a case of transjugular transcatheter tricuspid valve replacement (TTVR) for persistent severe tricuspid regurgitation after transcatheter aortic valve replacement. The patient was an 80 year old female who underwent transcatheter aortic valve replacement at the Department of Cardiology, West China Hospital, Sichuan University, two months before admission. After the surgery, her condition worsened due to unimproved tricuspid regurgitation and right heart failure. After admission, the patient underwent transjugular TTVR under general anesthesia. With the assistance of cardiac ultrasound and X-ray fluoroscopy, an artificial valve was successfully implanted, and tricuspid regurgitation was relieved. The patient’s surgery went smoothly, and the condition improved significantly 25 days after surgery. The patient was discharged 34 days after surgery.

1.	Russo G, Taramasso M, Pedicino D, et al. Challenges and future perspectives of transcatheter tricuspid valve interventions: adopt old strategies or adapt to new opportunities?. Eur J Heart Fail, 2022, 24(3): 442-454.
2.	Topilsky Y, Maltais S, Medina Inojosa J, et al. Burden of tricuspid regurgitation in patients diagnosed in the community setting. JACC Cardiovasc Imaging, 2019, 12(3): 433-442.
3.	Dreyfus J, Komar M, Attias D, et al. Tricuspid regurgitation: frequency, clinical presentation, management and outcome among patients with severe left-sided valvular heart disease in Europe. Insights from the ESC-EORP Valvular Heart Disease II survey. Eur J Heart Fail, 2024, 26(4): 994-1003.
4.	Shiran A, Sagie A. Tricuspid regurgitation in mitral valve disease incidence, prognostic implications, mechanism, and management. J Am Coll Cardiol, 2009, 53(5): 401-408.
5.	Rajbanshi BG, Suri RM, Nkomo VT, et al. Influence of mitral valve repair versus replacement on the development of late functional tricuspid regurgitation. J Thorac Cardiovasc Surg, 2014, 148(5): 1957-1962.
6.	Kavsur R, Iliadis C, Spieker M, et al. Predictors and prognostic relevance of tricuspid alterations in patients undergoing transcatheter edge-to-edge mitral valve repair. EuroIntervention, 2021, 17(10): 827-834.
7.	Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. EuroIntervention, 2022, 17(14): e1126-e1196.
8.	Kim JB, Jung SH, Choo SJ, et al. Clinical and echocardiographic outcomes after surgery for severe isolated tricuspid regurgitation. J Thorac Cardiovasc Surg, 2013, 146(2): 278-284.
9.	Guenther T, Noebauer C, Mazzitelli D, et al. Tricuspid valve surgery: a thirty-year assessment of early and late outcome. Eur J Cardiothorac Surg, 2008, 34(2): 402-409.
10.	Atluri P, Iyengar A, Rekhtman D. Risks and benefits of concomitant tricuspid surgery at the time of mitral intervention. J Am Coll Cardiol, 2024, 83(17): 1669-1670.
11.	Gaemperli O, Biaggi P, Gugelmann R, et al. Real-time left ventricular pressure-volume loops during percutaneous mitral valve repair with the MitraClip system. Circulation, 2013, 127(9): 1018-1027.
12.	Toselli M, Fisicaro A, Squeri A, et al. A case of catheter-based tricuspid valve repair reversing the previous success of transcatheter mitral valve repair: a new scenario requires new answers. Can J Cardiol, 2022, 38(1): 123-125.
13.	Staubach S, Sailer M, Koch J, et al. Tricuspid transcatheter edge-to-edge repair in a 72-year-old patient with a left ventricular assist device and prior mitral edge-to-edge repair: a case report. Eur Heart J Case Rep, 2024, 8(3): ytae074.
14.	Goldberg YH, Ho E, Chau M, et al. Update on transcatheter tricuspid valve replacement therapies. Front Cardiovasc Med, 2021, 8: 619558.
15.	Lu FL, Ma Y, An Z, et al. First-in-man experience of transcatheter tricuspid valve replacement with LuX-Valve in high-risk tricuspid regurgitation patients. JACC Cardiovasc Interv, 2020, 13(13): 1614-1616.
16.	Zack CJ, Fender EA, Chandrashekar P, et al. National trends and outcomes in isolated tricuspid valve surgery. J Am Coll Cardiol, 2017, 70(24): 2953-2960.
17.	Messika-Zeitoun D, Verta P, Gregson J, et al. Impact of tricuspid regurgitation on survival in patients with heart failure: a large electronic health record patient-level database analysis. Eur J Heart Fail, 2020, 22(10): 1803-1813.
18.	Alperi A, Almendárez M, Álvarez R, et al. Transcatheter tricuspid valve interventions: current status and future perspectives. Front Cardiovasc Med, 2022, 9: 994502.

1. Russo G, Taramasso M, Pedicino D, et al. Challenges and future perspectives of transcatheter tricuspid valve interventions: adopt old strategies or adapt to new opportunities?. Eur J Heart Fail, 2022, 24(3): 442-454.
2. Topilsky Y, Maltais S, Medina Inojosa J, et al. Burden of tricuspid regurgitation in patients diagnosed in the community setting. JACC Cardiovasc Imaging, 2019, 12(3): 433-442.
3. Dreyfus J, Komar M, Attias D, et al. Tricuspid regurgitation: frequency, clinical presentation, management and outcome among patients with severe left-sided valvular heart disease in Europe. Insights from the ESC-EORP Valvular Heart Disease II survey. Eur J Heart Fail, 2024, 26(4): 994-1003.
4. Shiran A, Sagie A. Tricuspid regurgitation in mitral valve disease incidence, prognostic implications, mechanism, and management. J Am Coll Cardiol, 2009, 53(5): 401-408.
5. Rajbanshi BG, Suri RM, Nkomo VT, et al. Influence of mitral valve repair versus replacement on the development of late functional tricuspid regurgitation. J Thorac Cardiovasc Surg, 2014, 148(5): 1957-1962.
6. Kavsur R, Iliadis C, Spieker M, et al. Predictors and prognostic relevance of tricuspid alterations in patients undergoing transcatheter edge-to-edge mitral valve repair. EuroIntervention, 2021, 17(10): 827-834.
7. Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS guidelines for the management of valvular heart disease. EuroIntervention, 2022, 17(14): e1126-e1196.
8. Kim JB, Jung SH, Choo SJ, et al. Clinical and echocardiographic outcomes after surgery for severe isolated tricuspid regurgitation. J Thorac Cardiovasc Surg, 2013, 146(2): 278-284.
9. Guenther T, Noebauer C, Mazzitelli D, et al. Tricuspid valve surgery: a thirty-year assessment of early and late outcome. Eur J Cardiothorac Surg, 2008, 34(2): 402-409.
10. Atluri P, Iyengar A, Rekhtman D. Risks and benefits of concomitant tricuspid surgery at the time of mitral intervention. J Am Coll Cardiol, 2024, 83(17): 1669-1670.
11. Gaemperli O, Biaggi P, Gugelmann R, et al. Real-time left ventricular pressure-volume loops during percutaneous mitral valve repair with the MitraClip system. Circulation, 2013, 127(9): 1018-1027.
12. Toselli M, Fisicaro A, Squeri A, et al. A case of catheter-based tricuspid valve repair reversing the previous success of transcatheter mitral valve repair: a new scenario requires new answers. Can J Cardiol, 2022, 38(1): 123-125.
13. Staubach S, Sailer M, Koch J, et al. Tricuspid transcatheter edge-to-edge repair in a 72-year-old patient with a left ventricular assist device and prior mitral edge-to-edge repair: a case report. Eur Heart J Case Rep, 2024, 8(3): ytae074.
14. Goldberg YH, Ho E, Chau M, et al. Update on transcatheter tricuspid valve replacement therapies. Front Cardiovasc Med, 2021, 8: 619558.
15. Lu FL, Ma Y, An Z, et al. First-in-man experience of transcatheter tricuspid valve replacement with LuX-Valve in high-risk tricuspid regurgitation patients. JACC Cardiovasc Interv, 2020, 13(13): 1614-1616.
16. Zack CJ, Fender EA, Chandrashekar P, et al. National trends and outcomes in isolated tricuspid valve surgery. J Am Coll Cardiol, 2017, 70(24): 2953-2960.
17. Messika-Zeitoun D, Verta P, Gregson J, et al. Impact of tricuspid regurgitation on survival in patients with heart failure: a large electronic health record patient-level database analysis. Eur J Heart Fail, 2020, 22(10): 1803-1813.
18. Alperi A, Almendárez M, Álvarez R, et al. Transcatheter tricuspid valve interventions: current status and future perspectives. Front Cardiovasc Med, 2022, 9: 994502.

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