title: Transcatheter valve-in-valve implantation in the tricuspid position.
abstract: OBJECTIVE
  Transcatheter implantation of valved stents (Melody and Edwards valves) for replacement of the pulmonary valve is currently an established procedure. We reviewed our experience on implantation of such valves in the tricuspid valve position.
  
  
  RESULTS
  Transcatheter valve implantation in the tricuspid position was attempted in five patients. Four patients had predominantly tricuspid valve regurgitation, two of whom also had tricuspid valve stenosis. All patients had severely symptomatic right heart failure. Patient median age and weight were 12 years and 50 kg (range six-43 years and 13-68 kg, respectively). All patients had a bioprosthetic valve already in place. The mean gradient across the tricuspid valve decreased from 12 to 3 mmHg after the procedure. Median procedure time and fluoroscopy time were 100 and 39 min (range 60-180 and 30-57 min, respectively). The patients' functional class improved from NYHA Class III to II in three and from Class III to I in two patients during a follow-up period of 15-22 months.
  
  
  CONCLUSIONS
  Transcatheter replacement of malfunctioning bioprosthetic valves in the tricuspid position using valved stents is an attractive alternative to repeat surgery in high-risk or multi-operated patients. Longer follow-up and a larger number of patients are required to establish the long-term benefit of the procedure and freedom from reinterventions.
authors.affiliation: Department of Congenital Heart Disease, Mitera Children's Hospital, Athens, Greece.
authors.forename: Aphrodite
authors.initials: A
authors.lastname: Tzifa
authors.forename: Tarek
authors.initials: T
authors.lastname: Momenah
authors.forename: Atif
authors.initials: A
authors.lastname: Al Sahari
authors.forename: Khalaf
authors.initials: K
authors.lastname: Al Khalaf
authors.forename: John
authors.initials: J
authors.lastname: Papagiannis
authors.forename: Shakeel A
authors.initials: SA
authors.lastname: Qureshi
mesh_terms: D000293:Adolescent; D000328:Adult; D001705:Bioprosthesis; D006328:Cardiac Catheterization / Q000379:methods*; D002648:Child; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D011475:Prosthesis Failure; D014262:Tricuspid Valve Insufficiency / Q000601:surgery*; D014264:Tricuspid Valve Stenosis / Q000601:surgery*