title: Transapical tricuspid valve-in-ring implantation: An alternative approach to a challenging clinical scenario.
abstract: We report on a transapical tricuspid valve-in-ring implantation performed via right ventricular apex using the Sapien-XT-prosthesis. A 57-year-old woman with recurrent episodes of right heart failure and three previous sternotomies, including tricuspid valve repair with a 32 mm Carpentier-Edwards-Classic annuloplasty ring was admitted due to recurrent severe tricuspid regurgitation. Given the excessive surgical risk, a 29 mm Sapien-XT-prosthesis was selected for valve-in-ring implantation. Transapical valve-in-ring implantation procedure was uneventful. Predischarge echocardiography showed only trace paravalvular tricuspid regurgitation in the septal region. Transapical approach via right ventricular apex is a viable alternative for tricuspid valve-in-ring implantation in selected high-risk patients. © 2016 Wiley Periodicals, Inc.
authors: Department of Cardiovascular Surgery, University Heart Center Hamburg, Hamburg, Germany.
authors: Evaldas
authors: E
authors: Girdauskas
authors: Department of Cardiology, Heart Center Bad Berka, Bad Berka, Germany.
authors: Bernward
authors: B
authors: Lauer
authors: Cardiac Surgery, Heart Center Bad Berka, Bad Berka, Germany.
authors: Thomas
authors: T
authors: Kuntze
mesh_terms: D006328:Cardiac Catheterization / Q000295:instrumentation*; D058385:Cardiac Valve Annuloplasty / Q000009:adverse effects* / Q000295:instrumentation*; D018618:Echocardiography, Doppler, Color; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000295:instrumentation*; D006801:Humans; D008875:Middle Aged; D011474:Prosthesis Design; D011475:Prosthesis Failure; D020127:Recovery of Function; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014262:Tricuspid Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*
keywords: percutaneous valve therapy; structural heart disease intervention; transcatheter valve implantation