title: Transvenous transcatheter valve-in-valve implantation after bioprosthetic tricuspid valve failure.
abstract: We describe the case of a 38-year-old man with a history of metastatic testicular cancer who had undergone multiple thoracic surgical procedures, including tricuspid valve replacement with a bioprosthetic valve as a result of tricuspid involvement of his malignancy. He presented at our outpatient cardiology clinic with worsening fatigue, shortness of breath, and peripheral edema, investigation of which revealed severe tricuspid bioprosthesis stenosis with central regurgitation. Because of the patient's medical history, he was considered to be a high-risk surgical candidate. Therefore, transcatheter tricuspid valve-in-valve implantation of a 26-mm Edwards Sapien(®) valve was attempted through a transjugular approach. The procedure restored tricuspid valvar competence and substantially improved the patient's symptoms. We discuss the technical aspects of this case and briefly review the usefulness of the valve-in-valve technique in the tricuspid position.
authors.forename: Ali
authors.initials: A
authors.lastname: Mortazavi
authors.forename: Ross M
authors.initials: RM
authors.lastname: Reul
authors.forename: Leon
authors.initials: L
authors.lastname: Cannizzaro
authors.forename: Kathryn G
authors.initials: KG
authors.lastname: Dougherty
mesh_terms: D000328:Adult; D001705:Bioprosthesis; D006349:Heart Valve Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D008297:Male; D011475:Prosthesis Failure; D014261:Tricuspid Valve
keywords: Heart valve prosthesis; heart valve pros-thesis implantation/instrumentation/methods/trends; prosthesis design; surgical procedures, minimally invasive/methods; treatment outcome; tricuspid valve insufficiency; tricuspid valve stenosis/therapy