scholarly journals Percutaneous Treatment of Tricuspid Regurgitation

2021 ◽  
Author(s):  
Carlos Minguito-Carazo ◽  
Tomás Benito-González ◽  
Rodrigo Estévez-Loureiro ◽  
Carmen Garrote-Coloma ◽  
Julio Echarte-Morales ◽  
...  
Keyword(s):  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Heart Surgery ◽  
Ventricular Remodeling ◽  
Open Heart Surgery ◽  
Unmet Need ◽  
Vena Cava ◽  
Percutaneous Treatment ◽  
Tricuspid Valve Annulus ◽  
Valve Implantation

Tricuspid valve regurgitation is one of the most common valvular disorders and moderate to severe tricuspid regurgitation is consistently associated to an increased morbidity and mortality. From an etiopathological perspective, tricuspid regurgitation can be classified in primary, due to the organic disease of any of the valve components, or secondary, as a result of tricuspid valve annulus dilatation, adverse right ventricular remodeling and tricuspid valve leaflet tethering. Despite its poor prognosis, most patients with tricuspid insufficiency are managed conservatively and only those with concomitant left heart valvular disease do finally go surgery in the real-world setting. In fact, outcomes of conventional surgery in patients with isolated tricuspid regurgitation are poor and this approach has not proven yet any survival benefit over stand-alone medical therapy. Given this unmet need, new transcatheter techniques have been developed in the last years, including leaflet plication, percutaneous annuloplasty and valve implantation in either the tricuspid position (orthotopic implantation) or in a different position such as the vena cava (heterotopic implantation). These techniques, with promising outcomes, are seen as an interesting alternative to open-heart surgery given the much lower periprocedural risk.

scholarly journals Caval Valve Implantation (CAVI): An Emerging Therapy for Treating Severe Tricuspid Regurgitation

2021 ◽  
Vol 10 (19) ◽  
pp. 4601
Author(s):  
Omar Abdul-Jawad Altisent ◽  
Rimantas Benetis ◽  
Vaida Mizarien ◽  
Francisco Gual-Capllonch ◽  
Eduard Fernandez-Nofrerias ◽  
...  
Keyword(s):  
Tricuspid Regurgitation ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Feasibility Studies ◽  
Heart Valve Disease ◽  
Current Evidence ◽  
High Morbidity ◽  
Suitable Alternative ◽  
Severe Tricuspid Regurgitation ◽  
Valve Implantation

Severe tricuspid regurgitation remains a challenging heart-valve disease to effectively treat with high morbidity and mortality at mid-term. Currently guideline-directed medical treatment is limited to escalating dose of diuretics, and the rationale and timing of open-heart surgery remains controversial. Emerging percutaneous therapies for severe tricuspid regurgitation continue to show promising results in early feasibility studies. However, randomized trial data is lacking. Additionally, many patients are deemed unsuitable for these emerging therapies due to anatomical or imaging constraints. Given the technical simplicity of the bicaval valve implantation (CAVI) technique compared to other transcatheter devices, CAVI is postulated as a suitable alternative for a wide variety of patients affected with severe+ tricuspid regurgitation. In this review we illustrate the current evidence and ongoing uncertainties of CAVI, focusing on the novel CAVI-specific devices.

scholarly journals Surgical Bailout Therapy after Implantation of a Medtronic CoreValve Bioprosthesis

2012 ◽  
Vol 2012 ◽  
pp. 1-4
Author(s):  
Rita Calé ◽  
José Neves ◽  
Rui Teles ◽  
João Brito ◽  
Miguel Abecasis ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Heart Surgery ◽  
Ventricular Remodeling ◽  
Left Ventricular Remodeling ◽  
Open Heart Surgery ◽  
Left Ventricular ◽  
Paravalvular Leak ◽  
Transcatheter Aortic Valve ◽  
Hemodynamic Deterioration ◽  
Valve Implantation

Moderate-to-severe paraprosthesic leak causing hemodynamic deterioration and left ventricular remodeling can occur after transcatheter aortic valve implantation (TAVI). We present the case of a 75-year-old woman who underwent TAVI with a 26 mm CoreValve prosthesis complicated with an acute left ventricle dilatation due to a severe paravalvular leak. Patient was unresponsive to elective balloon post-dilatation, and therefore she was successfully treated with open-heart surgery to remove the malfunctioning CoreValve bioprosthesis and perform standard aortic valve replacement.

scholarly journals Heterotopic caval valve implantation for the management of severe tricuspid regurgitation: a case series

2020 ◽  
Author(s):  
Aidan Sharkey ◽  
Ronny Munoz Acuna ◽  
Kiran Belani ◽  
Ravi K Sharma ◽  
Omar Chaudhary ◽  
...  
Keyword(s):  
Medical Therapy ◽  
Tricuspid Regurgitation ◽  
Surgical Intervention ◽  
Symptom Relief ◽  
Vena Cava ◽  
Case Series ◽  
High Morbidity ◽  
Severe Tricuspid Regurgitation ◽  
Maximal Medical Therapy ◽  
Valve Implantation

Abstract Background Severe tricuspid regurgitation (TR) is a complex condition that can be difficult to treat medically, and often surgical intervention is prohibited due to the high morbidity and mortality associated with this intervention. In patients who have failed maximal medical therapy and have progressive symptoms related to their severe TR, heterotopic caval valve implantation (CAVI) offers potential for symptom relief for these patients. Case summary We present two cases of patients with severe TR with symptoms of heart failure that were refractory to medical therapy. Due to extensive comorbidities in these patient’s surgical intervention was deemed unsuitable and the decision was made to proceed with heterotopic CAVI in order to try and control their symptoms. Both patients successfully underwent the procedure and had an Edwards SAPIEN 3 valve (Edwards Lifesciences, Irvine, CA, USA) implanted in the inferior vena cava/right atrium junction. In both patients, there was improvement in the postoperative haemodynamics as measured by invasive and non-invasive methods. Successful discharge was achieved in both patients with improvement in their symptoms. Discussion Selective use of heterotopic CAVI to treat symptomatic severe TR that is refractory to medical therapy may be a viable option to improve symptoms in those patients that are unsuitable for surgical intervention.

Superior vena cava syndrome after open heart surgery

1992 ◽  
Vol 59 (1) ◽  
pp. 93-95 ◽  
Author(s):  
H. J. Maggiano ◽  
T. L. Higgins ◽  
W. Lobo ◽  
G. Makos ◽  
L. A. R. Golding
Keyword(s):  
Superior Vena Cava ◽  
Heart Surgery ◽  
Superior Vena Cava Syndrome ◽  
Superior Vena ◽  
Open Heart Surgery ◽  
Vena Cava ◽  
Open Heart ◽  
Vena Cava Syndrome

scholarly journals Case report of simultaneous transcatheter mitral valve-in-valve implantation and percutaneous closure of two paravalvular leaks

2019 ◽  
Vol 3 (3) ◽  
Author(s):  
Masahiko Asami ◽  
Thomas Pilgrim ◽  
Stephan Windecker ◽  
Fabien Praz
Keyword(s):  
Mitral Valve ◽  
Heart Surgery ◽  
Open Heart Surgery ◽  
Transoesophageal Echocardiography ◽  
Paravalvular Leak ◽  
Open Heart ◽  
Surgical Risk ◽  
Significant Difference ◽  
Valve In Valve ◽  
Valve Implantation

Abstract Background Concomitant structural degeneration of surgical mitral bioprostheses and paravalvular leak (PVL) is rare but potentially fatal. Data pertaining to simultaneous transcatheter mitral valve implantation (TMVI) and percutaneous PVL closure are limited, and the optimal treatment strategy remains undetermined. We report a case of simultaneous TMVI and double percutaneous PVL closure in a patient with a degenerated bioprosthetic mitral valve and associated medial and lateral PVLs. Case summary A 75-year-old woman who underwent combined aortic (Edwards Perimount Magna 19 mm) and mitral (Edwards Perimount Magna 25 mm) surgical valve replacement 6 years ago was referred for treatment of new-onset orthopnoea and severely reduced exercise capacity. Transoesophageal echocardiography revealed severe mitral stenosis and concomitant moderate to severe mitral regurgitation, originating from two PVLs located medial and lateral from the surgical bioprosthesis. Due to high surgical risk, we performed successful transseptal mitral valve-in-valve (ViV) implantation combined with the closure of two PVLs during the same procedure. Discussion Although surgery should be considered as a first-line treatment in this setting, most patients have extremely high or prohibitive surgical risk inherent to repeat open heart surgery. Mitral ViV implantation appears a reasonable treatment option for patients with failed mitral bioprostheses. Furthermore, a recent study of percutaneous PVL closure showed no significant difference in long-term all-cause mortality compared with redo open-heart surgery. Simultaneous TMVI and percutaneous PVL closure appears feasible in selected high-risk patients.

Extravascular obstruction of the superior vena cava by hematoma after open-heart surgery and diagnosis by scintigraphy

1983 ◽  
Vol 51 (7) ◽  
pp. 1229-1231 ◽  
Author(s):  
Mason H. Weiss ◽  
Timothy M. Bateman ◽  
Robert M. Kass ◽  
David E. Brown ◽  
Daniel S. Berman ◽  
...  
Keyword(s):  
Superior Vena Cava ◽  
Heart Surgery ◽  
Superior Vena ◽  
Open Heart Surgery ◽  
Vena Cava ◽  
Open Heart

scholarly journals Intravascular leiomyomatosis with cardiac extension: a case report

2022 ◽  
Author(s):  
Einat Shaked ◽  
Ram Sharoni ◽  
Debra Gershov West ◽  
Eli I Lev
Keyword(s):  
Inferior Vena Cava ◽  
Clinical Condition ◽  
Heart Surgery ◽  
Inferior Vena ◽  
Multimodality Imaging ◽  
Open Heart Surgery ◽  
Vena Cava ◽  
Abdominal Ultrasound ◽  
Right Heart ◽  
The Right

Abstract Background Intravascular leiomyomatosis with intracardiac extension is a rare benign tumor seen exclusively in women, characterized by proliferation of uterine smooth muscle cells through the venous circulation into the inferior vena cava and the right heart chambers. Case summary A 47 years old women with history of previous hysterectomy due to myomatosis, presented with nausea, anorexia and bilateral lower limb swelling over the preceding two months. An outpatient abdominal ultrasound discovered a mass in the Inferior vena cava. Echocardiogram and Computed tomography demonstrated a large intravascular mass extending from the pelvis to the right heart chambers. The tumor was completely removed in a concomitant open-heart surgery and laparotomy. Post operative course was uncomplicated. A month later the patient was feeling well and in good clinical condition. The histological analysis consisted with intravascular leiomyomatosis. Discussion Intracardiac leiomyomatosis is a rare clinical condition which requires high index of suspicion. Multimodality imaging is usually required to establish the preoperative diagnosis, although the final diagnosis is achieved with tissue investigation. Complete surgical resection of the tumor is curative and associated with good long-term prognosis.

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