Despite its wide prevalence, being most often secondary to left-side valve disease, tricuspid regurgitation (TR) has been an underestimated condition in the medical literature for a long time, and for decades, the tricuspid valve (TV) has been referred to as the “forgotten valve.” Based on this, with perhaps exceptions for congenital conditions, isolated TV surgery (represented by surgical valve replacement or repair with ring) is performed infrequently and often TV treatment, especially in terms of repair, is performed in the context of surgical treatment of the mitral and/or aortic valve, thus prolonging operative times and periprocedural risks. Anyhow, durability of surgical interventions on TV is still controversial. Recently, in the context of degenerated TV bioprosthesis or ring failure, transcatheter valve-in-valve or valve-in-ring procedures with off-label use of transcatheter aortic and pulmonary valve bioprosthesis have been recently spread, in order to perform reintervention in a minimally invasive way in high-risk patients. In the present chapter, we assessed the epidemiology of surgical bioprosthesis degeneration and ring failure on TV, the type of transcatheter bioprosthesis available for treatment, the preprocedural assessment and technical features, as well as the postprocedural outcomes derived from literature.

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Valve-in-Valve and Valve-in-Ring on Tricuspid Valve

  • Nedy Brambilla,
  • Lorenzo Tua,
  • Antonio Popolo Rubbio

摘要

Despite its wide prevalence, being most often secondary to left-side valve disease, tricuspid regurgitation (TR) has been an underestimated condition in the medical literature for a long time, and for decades, the tricuspid valve (TV) has been referred to as the “forgotten valve.” Based on this, with perhaps exceptions for congenital conditions, isolated TV surgery (represented by surgical valve replacement or repair with ring) is performed infrequently and often TV treatment, especially in terms of repair, is performed in the context of surgical treatment of the mitral and/or aortic valve, thus prolonging operative times and periprocedural risks. Anyhow, durability of surgical interventions on TV is still controversial. Recently, in the context of degenerated TV bioprosthesis or ring failure, transcatheter valve-in-valve or valve-in-ring procedures with off-label use of transcatheter aortic and pulmonary valve bioprosthesis have been recently spread, in order to perform reintervention in a minimally invasive way in high-risk patients. In the present chapter, we assessed the epidemiology of surgical bioprosthesis degeneration and ring failure on TV, the type of transcatheter bioprosthesis available for treatment, the preprocedural assessment and technical features, as well as the postprocedural outcomes derived from literature.