scholarly journals A case report: intravalvular regurgitation during percutaneous valve-in-ring implantation due to eccentric bulging of a balloon-expandable valve in a patient with severe right heart failure

2019 ◽  
Author(s):  
Muhammed Gerçek ◽  
René Schramm ◽  
Lech Paluszkiewicz ◽  
Tanja Katharina Rudolph
Keyword(s):  
Heart Failure ◽  
Tricuspid Valve ◽  
Heart Function ◽  
Right Heart Failure ◽  
Alternative Methods ◽  
Tricuspid Valve Repair ◽  
Heart Team ◽  
Valve Repair ◽  
Right Heart ◽  
Right Heart Function

Abstract Background Severely reduced right heart function and high operative risk are major challenges in the treatment of tricuspid regurgitation (TR) as both can lead to low cardiac output heart failure (LCO-Hf). Alternative methods and criteria for patient selection are actively being sought. Case summary We report on a 66-year-old patient with severe right heart failure (rHF) with recurrent TR after prior surgical valve repair with a 32-mm-Edwards-MC3 annuloplasty ring (AR). Surgical revision was discarded due to extreme high surgical risk. A right ventricular assist device was discussed but declined by the patient. Percutaneous edge-to-edge repair was not applicable due to massive tethering of the anterior leaflet and complete lack of coadaptation. According to the Heart team decision, percutaneous tricuspid valve-in-ring implantation was performed using a 29-mm Sapien-3 prosthesis (SP3) under moderate balloon overinflation. Despite satisfying positioning, the prosthesis showed massive intravalvular regurgitation due to immobility of the septally oriented cusp, which was most likely caused by eccentric bulging of the prosthesis in the opening region of the AR. Implantation of a second prosthesis leads to a perfectly functional result. Importantly, no major haemodynamic complications ensued. Discussion Although being a potential risk of tricuspid valve repair LCO-hf could not be observed in the present case. Additionally, deformation of the implanted transcatheter aortic valve replacement prosthesis resulting from the regional lack of abutment in AR should be considered as a potential complication. Hence, further careful evaluation of the feasibility of percutaneous tricuspid valve treatment, also in patients with rHF, is needed.

Concomitant Tricuspid Valve Repair in Patients Undergoing LVAD Placement Reduces Incidence of Acute Right Heart Failure

2013 ◽  
Vol 32 (4) ◽  
pp. S55-S56
Author(s):  
L.E. Rodriguez ◽  
B.A. Bruckner ◽  
T. Motomura ◽  
J.D. Estep ◽  
B. Trachtenberg ◽  
...  
Keyword(s):  
Heart Failure ◽  
Tricuspid Valve ◽  
Right Heart Failure ◽  
Tricuspid Valve Repair ◽  
Valve Repair ◽  
Right Heart

Micra Leadless Pacemaker Implantation and Tricuspid Valve Repair with Mitraclip NT in a Patient with End-Stage Right Heart Failure

2018 ◽  
Vol 2 (6) ◽  
pp. 567-568
Author(s):  
Rodrigo Estévez-Loureiro ◽  
Vanessa Moñivas ◽  
Jorge Toquero ◽  
Juan Francisco Oteo ◽  
Javier Segovia ◽  
...  
Keyword(s):  
Heart Failure ◽  
Tricuspid Valve ◽  
Pacemaker Implantation ◽  
Right Heart Failure ◽  
Tricuspid Valve Repair ◽  
Valve Repair ◽  
Right Heart ◽  
Leadless Pacemaker ◽  
End Stage

scholarly journals Phenotyping right heart function for prognosticating heart failure

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
J Cho ◽  
T Uejima ◽  
H Hayama ◽  
Y Yajima ◽  
Y Yamashita
Keyword(s):  
Heart Failure ◽  
Cluster Analysis ◽  
Right Ventricular ◽  
Heart Function ◽  
Hazard Analysis ◽  
Right Heart Failure ◽  
Left Heart ◽  
Right Heart ◽  
Right Heart Function ◽  
Rv Function

Abstract Funding Acknowledgements Type of funding sources: None. Background Right heart failure has been shown to portend poor prognosis. The pathophysiology of right heart function is complex, as right ventricular (RV) function is easily affected by preload and afterload. Purpose To test the hypothesis that machine learning would detect heterogeneity in right heart function and improve risk stratifications in a heart failure population Methods This study included 403 heart failure patients who had a history of hospitalization for decompensation. Patients were excluded if they had primary heart valve disease or pericardial disease or a previous cardiac surgery. Hierarchical clustering was undertaken on right heart variables (RV strain, right ventricular systolic pressure (RVSP), vena contracta of tricuspid regurgitation (TR) and diameter of inferior vena cava) to identify homogenous groups of patients with similar profiles of the variables. Cox hazard analysis was used to elucidate the benefit of clustering over each variable for prognosticating heart failure. Endpoint was hospitalization for worsening heart failure. Results Cluster analysis identified three groups with distinct right heart function. Cluster 1 (n = 191) represented patients with preserved RV function and low RVSP (figure A).  On the other hand, cluster 2 (n = 144) had reduced RV function and low RVSP, while cluster 3 (n = 68) had preserved RV function and high RVSP, associated with severe TR and high central venous pressure. The latter 2 clusters carried worse outcome than cluster 1 (p < 0.001, figure B). Cox hazard analysis demonstrated that, although the addition of each right heart variable to baseline model constructed from left heart variables did not improve predictive power, clusters predicted events with a hazard ratio of 1.566, independent from and incremental to the left heart variables (Figure C). Conclusion Cluster analysis identified two distinct phenotypes of right heart failure that were associated with adverse outcomes. This data-driven phenotyping can help in categorizing right heart failure and better prognosticating heart failure. Abstract Figure.

Tricuspid valve repair via partial sternotomy for traumatic valve insufficiency

2021 ◽  
pp. 021849232110100
Author(s):  
Motohiro Maeda ◽  
Jiro Honda ◽  
Yosuke Ishi
Keyword(s):  
Tricuspid Valve ◽  
Chest Trauma ◽  
Right Heart Failure ◽  
Tricuspid Valve Repair ◽  
Valve Repair ◽  
Cardiac Trauma ◽  
Partial Sternotomy ◽  
Tricuspid Valve Insufficiency ◽  
Valve Insufficiency ◽  
Early Surgical Intervention

Tricuspid valve insufficiency rarely follows a blunt chest trauma. When the tricuspid valve is solely injured, the cardiac trauma may stay asymptomatic and tolerable, which often makes it difficult to determine the indication for surgery. We report a case of a patient with tricuspid regurgitation secondary to trauma due to a motorcycle accident. The patient was initially asymptomatic, but shortness of breath emerged two years after the accident. He underwent the tricuspid valve repair with chordae reconstruction and annuloplasty via lower partial sternotomy. We advocate that early surgical intervention prevents right heart failure, atrial fibrillation, and valve replacement.

scholarly journals Prognostic significance of the get with the guidelines-heart failure (GWTG-HF) risk score in patients undergoing trans-catheter tricuspid valve repair (TTVR)

2021 ◽  
Author(s):  
Refik Kavsur ◽  
Hannah Emmi Hupp-Herschel ◽  
Atsushi Sugiura ◽  
Tetsu Tanaka ◽  
Can Öztürk ◽  
...  
Keyword(s):  
Heart Failure ◽  
Renal Function ◽  
Mitral Regurgitation ◽  
Risk Stratification ◽  
Tricuspid Valve ◽  
Risk Score ◽  
Left Ventricular Ejection ◽  
Tricuspid Valve Repair ◽  
Valve Repair ◽  
Get With The Guidelines

AbstractThe Get-With-The-Guidelines-Heart-Failure (GWTG-HF) score is a risk assessment tool to predict mortality in patients with heart-failure (HF). We aimed to evaluate the GWTG-HF score for risk stratification in HF patients with tricuspid regurgitation undergoing trans-catheter tricuspid valve repair (TTVR). In total, 181 patients who underwent TTVR via edge-to-edge repair (86%) or annuloplasty (14%) were enrolled. Patients were categorized into a low- (≤ 43 points), intermediate- (44–53 points) and high-risk score groups (≥ 54 points). TTVR led to an improvement of TR (p < 0.0001) and NYHA (p < 0.0001). Kaplan–Meier analysis and log-rank test revealed that higher GWTG-HF scores were associated with reduced rates of event-free survival regarding mortality (96% vs 89% vs 73%, respectively, p = 0.001) and hospitalization for heart failure (HHF) (89% vs 86% vs 74%, respectively, p = 0.026). After adjusting for important variables like renal function, left ventricular ejection fraction and mitral regurgitation, the GWTG-HF score remained an independent predictor of the composite endpoint of HHF or mortality (hazard ratio 1.04 per 1-point increase, p = 0.029). Other remaining predictors were renal function and mitral regurgitation. The GWTG-HF score used as a risk stratification tool of mortality and HHF maintains its prognostic value in a HF population with severe TR undergoing TTVR.

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