Percutaneous interventions for tricuspid and pulmonary valve disease have emerged as transformative alternatives to conventional open-heart surgery, offering less invasive treatment options for patients often deemed high-risk. This chapter provides a comprehensive overview of the current landscape of these rapidly evolving catheter-based therapies. Focusing on the technical aspects and clinical outcomes, we delve into the various device platforms and procedural strategies employed for both tricuspid and pulmonary valve repair and replacement. For the tricuspid valve, discussions will encompass edge-to-edge repair techniques, annuloplasty devices, and orthotopic or heterotopic valve replacement systems, highlighting their respective indications, efficacy in reducing tricuspid regurgitation, and impact on right heart remodeling and patient symptoms. Similarly, the pulmonary section will explore transcatheter pulmonary valve implantation for native outflow tract disease and, more commonly, for dysfunction of previously surgically implanted conduits or valves. We will examine the nuances of patient selection, imaging guidance, potential complications, and long-term durability of these interventions. Emphasis will be placed on the multidisciplinary heart team approach essential for optimal patient management, considering the complex interplay of cardiac anatomy, comorbidities, and individual patient needs in tailoring the most appropriate percutaneous solution.

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Transcatheter Interventions for Tricuspid and Pulmonary Valve

  • Carina Ureche,
  • Igor Nedelciuc,
  • Alexandru Burlacu

摘要

Percutaneous interventions for tricuspid and pulmonary valve disease have emerged as transformative alternatives to conventional open-heart surgery, offering less invasive treatment options for patients often deemed high-risk. This chapter provides a comprehensive overview of the current landscape of these rapidly evolving catheter-based therapies. Focusing on the technical aspects and clinical outcomes, we delve into the various device platforms and procedural strategies employed for both tricuspid and pulmonary valve repair and replacement. For the tricuspid valve, discussions will encompass edge-to-edge repair techniques, annuloplasty devices, and orthotopic or heterotopic valve replacement systems, highlighting their respective indications, efficacy in reducing tricuspid regurgitation, and impact on right heart remodeling and patient symptoms. Similarly, the pulmonary section will explore transcatheter pulmonary valve implantation for native outflow tract disease and, more commonly, for dysfunction of previously surgically implanted conduits or valves. We will examine the nuances of patient selection, imaging guidance, potential complications, and long-term durability of these interventions. Emphasis will be placed on the multidisciplinary heart team approach essential for optimal patient management, considering the complex interplay of cardiac anatomy, comorbidities, and individual patient needs in tailoring the most appropriate percutaneous solution.