title: A rare case: bioprosthetic tricuspid valvuloplasty dramatically improved hepatic encephalopathy.
abstract: A 51-year-old woman was diagnosed as severe stenosed tricuspid bioprosthetic valve. She had developed an encephalopathy due to elevated serum ammonia concentration caused by congestive hepatic failure. Re-tricuspid valve replacement was deemed too risky, and balloon bioprosthetic valvuloplasty was instead planned. This procedure was successfully performed using a standard mitral valvuloplasty protocol. The 30-mm INOUE-BALLOON was inflated five times. The mean pressure gradient across the bioprosthetic valve decreased from 7.8 to 3.5 mmHg, and the tricuspid valve orifice area increased from 1.09 to 3.13 cm(2), without worsening of the tricuspid valve regurgitation. Finally, her hepatic encephalopathy was dramatically improved.
authors.affiliation: Yotsuba Circulation Clinic, Minami-edo 4-3-53, Matsuyama, Ehime, 790-0062, Japan. yokoyama.y@yotsuba-heart.jp.
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Yokoyama
authors.affiliation: Yotsuba Circulation Clinic, Minami-edo 4-3-53, Matsuyama, Ehime, 790-0062, Japan.
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Abe
authors.affiliation: Yotsuba Circulation Clinic, Minami-edo 4-3-53, Matsuyama, Ehime, 790-0062, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Fujieda
authors.affiliation: Yotsuba Circulation Clinic, Minami-edo 4-3-53, Matsuyama, Ehime, 790-0062, Japan.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Abe
mesh_terms: D063126:Balloon Valvuloplasty / Q000379:methods*; D001705:Bioprosthesis; D000075202:Contraindications; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation; D006501:Hepatic Encephalopathy / Q000150:complications / Q000628:therapy*; D006801:Humans; D008875:Middle Aged; D011475:Prosthesis Failure; D014262:Tricuspid Valve Insufficiency / Q000150:complications; D014264:Tricuspid Valve Stenosis / Q000150:complications / Q000628:therapy*
keywords: Balloon bioprosthetic valvuloplasty; Bioprosthetic heart valve; Tricuspid valve stenosis