Transcatheter Tricuspid Valve-in-Valve Replacement by Transatrial Approach

Reoperation on the tricuspid valve after prior heart valve surgery is associated with an increased operative risk due to a poor clinical status with severe heart failure and late presentation. Transcatheter tricuspid valve-in-valve implantation emerged as an attractive alternative to a high-risk redo surgery. The authors report a case of successful treatment of a failed bioprosthetic tricuspid valve in a 58-year-old woman with severe heart failure, decompensated cardiac cirrhosis and atrial fibrillation using transcatheter tricuspid valve-in-valve implantation of a Sapien 3 valve (Edwards Lifesciences, Irvine, California) via a transatrial approach. This case demonstrates the efficiency of this novel approach for the treatment of dysfunctional surgical tricuspid bioprosthetic valves and the technical feasibility and safety of a rarely used route.