TY - JOUR
T1 - Percutaneous Transcatheter Treatment for Tricuspid Bioprosthesis Failure
AU - Ruparelia, Neil
AU - Mangieri, Antonio
AU - Ancona, Marco
AU - Giannini, Francesco
AU - Agricola, Eustachio
AU - Montorfano, Matteo
AU - De Bonis, Michele
AU - Alfieri, Ottavio
AU - Colombo, Antonio
AU - Latib, Azeem
N1 - Publisher Copyright:
© 2016 Wiley Periodicals, Inc.
PY - 2016/11/15
Y1 - 2016/11/15
N2 - Objectives: To report procedural and 30-day outcomes following percutaneous transcatheter valve-in-valve (VIV) implantation for tricuspid bioprosthesis failure, with a new generation balloon-expandable transcatheter aortic valve implantation prosthesis. Background: Severe tricuspid regurgitation is associated with a reduction in survival and increased morbidity. Many patients previously treated with tricuspid valve replacement require further intervention due to bioprosthesis failure. Surgical redo is the “gold standard” treatment however this is technically challenging and associated with significant risk. Percutaneous VIV intervention that is now well established in the management of aortic and mitral bioprosthesis failure may therefore be an alternative treatment option. Methods: The study population consisted of all patients that underwent percutaneous transcatheter tricuspid VIV implantation for tricuspid bioprosthesis failure at the San Raffaele Scientific Institute, Milan, Italy. Results: Five patients underwent successful transfemoral transcatheter tricuspid VIV implantation for bioprosthetic failure. One patient suffered acute kidney injury that was successfully medically managed. The remaining patients suffered no complications prior to hospital discharge. During 30-day follow-up, all patients reported a significant improvement in their functional status with normal valve function. Additionally, we observed an improvement in renal function (eGFR baseline 62.0 ± 16.5 vs. follow-up 70.2 ± 23.1 ml/min/m2, P = 0.12) and improved hepatic congestion: bilirubin (1.47 ± 0.8 vs. 1.01 ± 0.7 mg/DL, P = 0.12), alanine aminotransferase (31.0 ± 11.1 vs. 23.2 ± 5.1 U/L, P = 0.11) and aspartate aminotransferase (35.8 ± 6.3 vs. 29.8 ± 13.6 U/L, P = 0.12). Conclusions: Transfemoral, transcatheter VIV treatment with a new generation balloon expandable devices appears to be a safe and efficacious treatment option for tricuspid bioprosthesis failure.
AB - Objectives: To report procedural and 30-day outcomes following percutaneous transcatheter valve-in-valve (VIV) implantation for tricuspid bioprosthesis failure, with a new generation balloon-expandable transcatheter aortic valve implantation prosthesis. Background: Severe tricuspid regurgitation is associated with a reduction in survival and increased morbidity. Many patients previously treated with tricuspid valve replacement require further intervention due to bioprosthesis failure. Surgical redo is the “gold standard” treatment however this is technically challenging and associated with significant risk. Percutaneous VIV intervention that is now well established in the management of aortic and mitral bioprosthesis failure may therefore be an alternative treatment option. Methods: The study population consisted of all patients that underwent percutaneous transcatheter tricuspid VIV implantation for tricuspid bioprosthesis failure at the San Raffaele Scientific Institute, Milan, Italy. Results: Five patients underwent successful transfemoral transcatheter tricuspid VIV implantation for bioprosthetic failure. One patient suffered acute kidney injury that was successfully medically managed. The remaining patients suffered no complications prior to hospital discharge. During 30-day follow-up, all patients reported a significant improvement in their functional status with normal valve function. Additionally, we observed an improvement in renal function (eGFR baseline 62.0 ± 16.5 vs. follow-up 70.2 ± 23.1 ml/min/m2, P = 0.12) and improved hepatic congestion: bilirubin (1.47 ± 0.8 vs. 1.01 ± 0.7 mg/DL, P = 0.12), alanine aminotransferase (31.0 ± 11.1 vs. 23.2 ± 5.1 U/L, P = 0.11) and aspartate aminotransferase (35.8 ± 6.3 vs. 29.8 ± 13.6 U/L, P = 0.12). Conclusions: Transfemoral, transcatheter VIV treatment with a new generation balloon expandable devices appears to be a safe and efficacious treatment option for tricuspid bioprosthesis failure.
KW - interventional devices/innovation
KW - percutaneous valve therapy
KW - structural heart disease intervention
KW - transcatheter valve implantation
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U2 - 10.1002/ccd.26584
DO - 10.1002/ccd.26584
M3 - Article
C2 - 27184831
AN - SCOPUS:84970006629
SN - 1522-1946
VL - 88
SP - 994
EP - 1001
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 6
ER -