Percutaneous tricuspid valve implantation: two-center experience with midterm results

Circ Cardiovasc Interv. 2015 Apr;8(4). pii: e002155. doi: 10.1161/CIRCINTERVENTIONS.114.002155.

Percutaneous tricuspid valve implantation: two-center experience with midterm results.

Eicken A1Schubert S2Hager A2Hörer J2McElhinney DB2Hess J2Ewert P2Berger F2.

Comment: In this study, Eicken and colleagues report a 2 center experience with percutaneous tricuspid valve implantation (PVTI). In the period from 2008-2014 the authors report on 17 PTVIs in 16 patients at 2 German Heart Centers (Munich and Berlin) with a median age of 31.3 years (7-55.2). Indications for PTVI corresponded to patient selection for TV surgery, but the underlying diagnosis was congenital heart disease in 14/16. 7 patients were treated with a Melody valve, 5 with a Sapien XT 29mm valve and 4 with a Sapien 26mm valve. Early in the study period the authors utilized pre-stenting in combination with the Melody valve but later on abandoned this practice thinking that it was unnecessary if the patient had a surgical bioprosthetic valve. The implantation was successful in all patients with only 1 peri-procedural complication (femoral vein injury) that resulted in no long term sequelae. The authors speculate that PTVI seems durable in the medium term with only 1 valve (Melody) requiring exchange at 1.5 years for recurrent severe tricuspid valve insufficiency and the rest (15/16) performing well at a median follow up of 2.1 years (3 days-6.3 years). The authors conclude that PTVI is technically feasible, safe, and effective in selected patients with dysfunction of surgical bioprostheses in TV position.