Preliminary exploration of the domestic balloon-expandable valve in the treatment of degenerated tricuspid bioprosthetic valve via transcatheter "valve-in-valve" technology_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

LI Lanlan , JIN Ping , LIU Yang , XU Chennian , MA Yanyan , LIU Jincheng ,  YANG Jian

Department of Cardiovascular Surgery, First Affiliated Hospital of Air Force Medical University, Xi'an, 710032, P.R.China;

Corresponding author：

YANG Jian, Email: yangjian1212@hotmail.com

Keywords：

Balloon-expandable valve; transcatheter tricuspid valve implantation; "valve-in-valve" technique; 3D printing technology

DOI：

10.7507/1007-4848.202104029

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To discuss the operation skill and clinical effects of using domestic balloon-expandable Prizvalve® transcatheter "valve-in-valve" to treat the degenerated bioprosthesis in the tricuspid position.Methods All the admitted surgical tricuspid valve bioprosthetic valve replacement patients were evaluated by computerized tomography angiography (CTA), ultrasound, and 3D printing technology, and 2 patients with a degenerated bioprosthesis were selected for tricuspid valve "valve-in-valve" operation. Under general anesthesia, the retro-preset Prizvalve® system was implanted into degenerated tricuspid bioprosthesis via the femoral vein approach under the guidance of transesophageal echocardiographic and fluoroscopic guidance.Results Transcatheter tricuspid valve implantation was successfully performed in both high-risk patients, and tricuspid regurgitation disappeared immediately. The operation time was 1.25 h and 2.43 h, respectively. There was no serious complication in both patients, and they were discharged from the hospital 7 days after the operation.Conclusion The clinical effect of the degenerated tricuspid bioprosthetic valve implantation with domestic balloon-expandable valve via femoral vein approach "valve-in-valve" is good. Multimodality imaging and 3D printing technology can safely and effectively guide the implementation of this innovative technique.

Citation： LI Lanlan, JIN Ping, LIU Yang, XU Chennian, MA Yanyan, LIU Jincheng, YANG Jian. Preliminary exploration of the domestic balloon-expandable valve in the treatment of degenerated tricuspid bioprosthetic valve via transcatheter "valve-in-valve" technology. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2021, 28(8): 908-914. doi: 10.7507/1007-4848.202104029 Copy

1.	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.
2.	Negm S, Arafat AA, Elatafy EE, et al. Mechanical versus bioprosthetic valve replacement in the tricuspid valve position: A systematic review and meta-analysis. Heart Lung Circ, 2021, 30(3): 362-371.
3.	Liu P, Qiao WH, Sun FQ, et al. Should a mechanical or biological prosthesis be ssed for a tricuspid valve replacement? A meta-analysis. J Card Surg, 2016, 31(5): 294-302.
4.	Morimoto N, Matsushima S, Aoki M, et al. Long-term results of bioprosthetic tricuspid valve replacement: An analysis of 25 years of experience. Gen Thorac Cardiovasc Surg, 2013, 61(3): 133-138.
5.	Jones JM, O'kane H, Gladstone DJ, et al. Repeat heart valve surgery: Risk factors for operative mortality. J Thorac Cardiovasc Surg, 2001, 122(5): 913-918.
6.	McElhinney DB, Cabalka AK, Aboulhosn JA, et al. Transcatheter tricuspid valve-in-valve implantation for the treatment of dysfunctional surgical bioprosthetic valves: An international, multicenter registry study. Circulation, 2016, 133(16): 1582-1593.
7.	McElhinney DB, Aboulhosn JA, Dvir D, et al. Mid-term valve-related outcomes after transcatheter tricuspid valve-in-valve or valve-in-ring replacement. J Am Coll Cardiol, 2019, 73(2): 148-157.
8.	Hahn RT, Waxman AB, Denti P, et al. Anatomic relationship of the complex tricuspid valve, right ventricle, and pulmonary vasculature: A review. JAMA Cardiol, 2019, 4(5): 478-487.
9.	Rodés-Cabau J, Taramasso M, O'Gara PT. Diagnosis and treatment of tricuspid valve disease: Current and future perspectives. Lancet, 2016, 388(10058): 2431-2442.
10.	Roberts P, Spina R, Vallely M, et al. Percutaneous tricuspid valve replacement for a stenosed bioprosthesis. Circ Cardiovasc Interv, 2010, 3(4): e14-e15.
11.	Kronberg K, Horn M, Mellert F, et al. Transcatheter tricuspid valve-in-valve replacement in two patients with Ebstein anomaly: Technical considerations. Clin Res Cardiol, 2021, 110(3): 472-477.
12.	Viotto G, Paim L, Souza R, et al. Early outcomes of transcatheter tricuspid valve-in-valve implantation: A case series. Interact Cardiovasc Thorac Surg, 2019, 29(1): 59-63.
13.	Praz F, George I, Kodali S, et al. Transcatheter tricuspid valve-in-valve intervention for degenerative bioprosthetic tricuspid valve disease. J Am Soc Echocardiogr, 2018, 31(4): 491-504.
14.	Ravani M, Koni E, Al Jabri A, et al. Transcatheter tricuspid valve-in-valve replacement in patients with large degenerated bioprostheses: Two case reports treated with Sapien 3 device using the new ultra delivery system. Cardiovasc Revasc Med, 2020, 21(11S): 3-7.
15.	Capretti G, Urena M, Bouleti C, et al. Transcatheter tricuspid valve-in-valve replacement: Making it simpler. Catheter Cardiovasc Interv, 2020, 95(1): 65-67.
16.	Bhamidipati CM, Scott Lim D, Ragosta M, et al. Percutaneous transjugular implantation of MELODY® valve into tricuspid bioprosthesis. J Card Surg, 2013, 28(4): 391-393.
17.	Elgharably H, Harb SC, Kapadia S, et al. Transcatheter innovations in tricuspid regurgitation: Navigate. Prog Cardiovasc Dis, 2019, 62(6): 493-495.
18.	马燕燕, 刘洋, 金屏, 等. 国产球囊扩张式瓣膜的临床应用初探. 中国介入心脏病学杂志, 2021, 29(2): 101-106.
19.	Spring AM, Pirelli L, Basman CL, et al. The importance of pre-operative imaging and 3-D printing in transcatheter tricuspid valve-in-valve replacement. Cardiovasc Revasc Med, 2020. [Epub ahead of print.
20.	Wang DD, Qian Z, Vukicevic M, et al. 3D printing, computational modeling, and artificial intelligence for structural heart disease. JACC Cardiovasc Imaging, 2021, 14(1): 41-60.

1. 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.
2. Negm S, Arafat AA, Elatafy EE, et al. Mechanical versus bioprosthetic valve replacement in the tricuspid valve position: A systematic review and meta-analysis. Heart Lung Circ, 2021, 30(3): 362-371.
3. Liu P, Qiao WH, Sun FQ, et al. Should a mechanical or biological prosthesis be ssed for a tricuspid valve replacement? A meta-analysis. J Card Surg, 2016, 31(5): 294-302.
4. Morimoto N, Matsushima S, Aoki M, et al. Long-term results of bioprosthetic tricuspid valve replacement: An analysis of 25 years of experience. Gen Thorac Cardiovasc Surg, 2013, 61(3): 133-138.
5. Jones JM, O'kane H, Gladstone DJ, et al. Repeat heart valve surgery: Risk factors for operative mortality. J Thorac Cardiovasc Surg, 2001, 122(5): 913-918.
6. McElhinney DB, Cabalka AK, Aboulhosn JA, et al. Transcatheter tricuspid valve-in-valve implantation for the treatment of dysfunctional surgical bioprosthetic valves: An international, multicenter registry study. Circulation, 2016, 133(16): 1582-1593.
7. McElhinney DB, Aboulhosn JA, Dvir D, et al. Mid-term valve-related outcomes after transcatheter tricuspid valve-in-valve or valve-in-ring replacement. J Am Coll Cardiol, 2019, 73(2): 148-157.
8. Hahn RT, Waxman AB, Denti P, et al. Anatomic relationship of the complex tricuspid valve, right ventricle, and pulmonary vasculature: A review. JAMA Cardiol, 2019, 4(5): 478-487.
9. Rodés-Cabau J, Taramasso M, O'Gara PT. Diagnosis and treatment of tricuspid valve disease: Current and future perspectives. Lancet, 2016, 388(10058): 2431-2442.
10. Roberts P, Spina R, Vallely M, et al. Percutaneous tricuspid valve replacement for a stenosed bioprosthesis. Circ Cardiovasc Interv, 2010, 3(4): e14-e15.
11. Kronberg K, Horn M, Mellert F, et al. Transcatheter tricuspid valve-in-valve replacement in two patients with Ebstein anomaly: Technical considerations. Clin Res Cardiol, 2021, 110(3): 472-477.
12. Viotto G, Paim L, Souza R, et al. Early outcomes of transcatheter tricuspid valve-in-valve implantation: A case series. Interact Cardiovasc Thorac Surg, 2019, 29(1): 59-63.
13. Praz F, George I, Kodali S, et al. Transcatheter tricuspid valve-in-valve intervention for degenerative bioprosthetic tricuspid valve disease. J Am Soc Echocardiogr, 2018, 31(4): 491-504.
14. Ravani M, Koni E, Al Jabri A, et al. Transcatheter tricuspid valve-in-valve replacement in patients with large degenerated bioprostheses: Two case reports treated with Sapien 3 device using the new ultra delivery system. Cardiovasc Revasc Med, 2020, 21(11S): 3-7.
15. Capretti G, Urena M, Bouleti C, et al. Transcatheter tricuspid valve-in-valve replacement: Making it simpler. Catheter Cardiovasc Interv, 2020, 95(1): 65-67.
16. Bhamidipati CM, Scott Lim D, Ragosta M, et al. Percutaneous transjugular implantation of MELODY® valve into tricuspid bioprosthesis. J Card Surg, 2013, 28(4): 391-393.
17. Elgharably H, Harb SC, Kapadia S, et al. Transcatheter innovations in tricuspid regurgitation: Navigate. Prog Cardiovasc Dis, 2019, 62(6): 493-495.
18. 马燕燕, 刘洋, 金屏, 等. 国产球囊扩张式瓣膜的临床应用初探. 中国介入心脏病学杂志, 2021, 29(2): 101-106.
19. Spring AM, Pirelli L, Basman CL, et al. The importance of pre-operative imaging and 3-D printing in transcatheter tricuspid valve-in-valve replacement. Cardiovasc Revasc Med, 2020. [Epub ahead of print.
20. Wang DD, Qian Z, Vukicevic M, et al. 3D printing, computational modeling, and artificial intelligence for structural heart disease. JACC Cardiovasc Imaging, 2021, 14(1): 41-60.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Preliminary exploration of the domestic balloon-expandable valve in the treatment of degenerated tricuspid bioprosthetic valve via transcatheter "valve-in-valve" technology

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