Faculty Collaboration Database

Outcomes of Transcatheter Tricuspid Valve-in-Valve Implantation in Patients With Ebstein Anomaly. Am J Cardiol 2018 Jan 15;121(2):262-268

Date

11/21/2017

Pubmed ID

29153244

DOI

10.1016/j.amjcard.2017.10.017

Scopus ID

2-s2.0-85033779789 (requires institutional sign-in at Scopus site)   36 Citations

Abstract

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.

Author List

Taggart NW, Cabalka AK, Eicken A, Aboulhosn JA, Thomson JDR, Whisenant B, Bocks ML, Schubert S, Jones TK, Asnes JD, Fagan TE, Meadows J, Hoyer M, Martin MH, Ing FF, Turner DR, Latib A, Tzifa A, Windecker S, Goldstein BH, Delaney JW, Kuo JA, Foerster S, Gillespie M, Butera G, Shahanavaz S, Horlick E, Boudjemline Y, Dvir D, McElhinney DB, VIVID Registry

Author

Susan Foerster MD Professor in the Pediatrics department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Bioprosthesis
Cardiac Catheterization
Ebstein Anomaly
Endocarditis
Female
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation
Humans
Male
Middle Aged
Postoperative Complications
Prosthesis Failure
Registries
Reoperation
Thrombosis
Treatment Outcome
Tricuspid Valve
Tricuspid Valve Insufficiency
Young Adult