Outcomes of Transcatheter Tricuspid Valve-in-Valve Implantation in Patients With Ebstein Anomaly.

Taggart, Nathaniel W; Cabalka, Allison K; Eicken, Andreas; Aboulhosn, Jamil A; Thomson, John D R; Whisenant, Brian; Bocks, Martin L; Schubert, Stephan; Jones, Thomas K; Asnes, Jeremy D; Fagan, Thomas E; Meadows, Jeffery; Hoyer, Mark; Martin, Mary H; Ing, Frank F; Turner, Daniel R; Latib, Azeem; Tzifa, Aphrodite; Windecker, Stephan; Goldstein, Bryan H; ... (2018). Outcomes of Transcatheter Tricuspid Valve-in-Valve Implantation in Patients With Ebstein Anomaly. American journal of cardiology, 121(2), pp. 262-268. Elsevier 10.1016/j.amjcard.2017.10.017

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We sought to describe the acute results and short- to medium-term durability of transcatheter tricuspid valve-in-valve (TVIV) implantation within surgical bioprostheses among patients with Ebstein anomaly (EA). Cases were identified from a voluntary, multicenter, international registry of 29 institutions that perform TVIV. Demographic, clinical, procedural, and follow-up data were analyzed. Eighty-one patients with EA underwent TVIV from 2008 to 2016. Thirty-four patients (42%) were New York Heart Association (NYHA) class 3/4 at time of TVIV. The most common indication for TVIV was the presence of moderate or severe tricuspid regurgitation (40%). Most patients received a Melody valve (64%). TVIV was ultimately successful in all patients, and there was no procedural mortality. Four patients (5%) developed acute valve thrombosis, 4 patients (5%) developed endocarditis, and 9 patients (11%) developed valve dysfunction not related to thrombosis or endocarditis. Eight patients (10%) underwent reintervention (2 transcatheter, 6 surgical) due to thrombosis (3), endocarditis (2), other valve dysfunction (2), and patient-prosthesis mismatch without valve dysfunction (1). Among 69 patients who were alive without reintervention at latest follow-up, 96% of those with NYHA status reported were class 1/2, a significant improvement from baseline (62% NYHA class 1/2, p <0.001). In conclusion, transcatheter TVIV offers a low-risk, minimally invasive alternative to surgical tricuspid valve re-replacement in patients with EA and a failing tricuspid valve bioprosthesis.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Windecker, Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0002-9149

Publisher:

Elsevier

Language:

English

Submitter:

Nadia Biscozzo

Date Deposited:

16 Apr 2018 11:23

Last Modified:

16 Apr 2018 11:23

Publisher DOI:

10.1016/j.amjcard.2017.10.017

PubMed ID:

29153244

BORIS DOI:

10.7892/boris.107397

URI:

https://boris.unibe.ch/id/eprint/107397

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