Transcatheter edge‐to‐edge tricuspid repair for recurrence of valvular regurgitation after left ventricular assist device and tricuspid ring implantation

Abstract Tricuspid regurgitation in patients with left ventricular assist device (LVAD) has a significant impact on prognosis and quality of life, and its effects on liver and renal function could negatively impact planned heart transplantation. The aim of the present case is to report the feasibili...

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Main Authors: Martin Andreas, Marco Russo, Paul Werner, Matthias Schneider, Franziska Wittmann, Sabine Scherzer, Julia Mascherbauer, Alfred Kocher, Guenther Laufer, Dominik Wiedemann, Daniel Zimpfer
Format: Article
Language:English
Published: Wiley 2020-06-01
Series:ESC Heart Failure
Subjects:
Online Access:https://doi.org/10.1002/ehf2.12577
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author Martin Andreas
Marco Russo
Paul Werner
Matthias Schneider
Franziska Wittmann
Sabine Scherzer
Julia Mascherbauer
Alfred Kocher
Guenther Laufer
Dominik Wiedemann
Daniel Zimpfer
author_facet Martin Andreas
Marco Russo
Paul Werner
Matthias Schneider
Franziska Wittmann
Sabine Scherzer
Julia Mascherbauer
Alfred Kocher
Guenther Laufer
Dominik Wiedemann
Daniel Zimpfer
author_sort Martin Andreas
collection DOAJ
description Abstract Tricuspid regurgitation in patients with left ventricular assist device (LVAD) has a significant impact on prognosis and quality of life, and its effects on liver and renal function could negatively impact planned heart transplantation. The aim of the present case is to report the feasibility and the clinical impact of tricuspid transcatheter edge‐to‐edge repair in LVAD patients as adjunctive bridge to transplantation strategy. A 59‐year‐old female patient previously treated with LVAD implantation (HeartMate III) and tricuspid valve repair with 32 mm rigid ring (Medtronic Contour 3D) as bridge to transplantation developed recurrence of significant tricuspid regurgitation with right ventricular decompensation needing inotropic support. Preoperative echo showed torrential tricuspid valve regurgitation Effective regurgitant orifice area(EROA 1.4 cm2) with suspicious of partial detachment of the prosthetic ring. The patient was successfully treated with transcatheter edge‐to‐edge repair with the MitraClip XTR device. Tricuspid regurgitation was reduced by 50% (postoperative EROA 0.7 cm2). She remained stable under continuous inotropic support with no other episodes of right ventricular decompensation and was successfully transplanted 30 days after the clipping procedure. Transcatheter treatment of tricuspid regurgitation in a patient with LVAD was an effective strategy to gain time and bridge the patient to heart transplantation.
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spelling doaj.art-f430ee4656d94fd3a061871776bb83942022-12-22T00:44:26ZengWileyESC Heart Failure2055-58222020-06-017391591910.1002/ehf2.12577Transcatheter edge‐to‐edge tricuspid repair for recurrence of valvular regurgitation after left ventricular assist device and tricuspid ring implantationMartin Andreas0Marco Russo1Paul Werner2Matthias Schneider3Franziska Wittmann4Sabine Scherzer5Julia Mascherbauer6Alfred Kocher7Guenther Laufer8Dominik Wiedemann9Daniel Zimpfer10Division of Cardiac Surgery, Department of Surgery Medical University of Vienna Währinger Gürtel 18‐20 Vienna 1090 AustriaDivision of Cardiac Surgery, Department of Surgery Medical University of Vienna Währinger Gürtel 18‐20 Vienna 1090 AustriaDivision of Cardiac Surgery, Department of Surgery Medical University of Vienna Währinger Gürtel 18‐20 Vienna 1090 AustriaDivision of Cardiology, Department of Internal Medicine II Medical University of Vienna Vienna AustriaDivision of Cardiac Surgery, Department of Surgery Medical University of Vienna Währinger Gürtel 18‐20 Vienna 1090 AustriaDivision of Cardiac Surgery, Department of Surgery Medical University of Vienna Währinger Gürtel 18‐20 Vienna 1090 AustriaDivision of Cardiology, Department of Internal Medicine II Medical University of Vienna Vienna AustriaDivision of Cardiac Surgery, Department of Surgery Medical University of Vienna Währinger Gürtel 18‐20 Vienna 1090 AustriaDivision of Cardiac Surgery, Department of Surgery Medical University of Vienna Währinger Gürtel 18‐20 Vienna 1090 AustriaDivision of Cardiac Surgery, Department of Surgery Medical University of Vienna Währinger Gürtel 18‐20 Vienna 1090 AustriaDivision of Cardiac Surgery, Department of Surgery Medical University of Vienna Währinger Gürtel 18‐20 Vienna 1090 AustriaAbstract Tricuspid regurgitation in patients with left ventricular assist device (LVAD) has a significant impact on prognosis and quality of life, and its effects on liver and renal function could negatively impact planned heart transplantation. The aim of the present case is to report the feasibility and the clinical impact of tricuspid transcatheter edge‐to‐edge repair in LVAD patients as adjunctive bridge to transplantation strategy. A 59‐year‐old female patient previously treated with LVAD implantation (HeartMate III) and tricuspid valve repair with 32 mm rigid ring (Medtronic Contour 3D) as bridge to transplantation developed recurrence of significant tricuspid regurgitation with right ventricular decompensation needing inotropic support. Preoperative echo showed torrential tricuspid valve regurgitation Effective regurgitant orifice area(EROA 1.4 cm2) with suspicious of partial detachment of the prosthetic ring. The patient was successfully treated with transcatheter edge‐to‐edge repair with the MitraClip XTR device. Tricuspid regurgitation was reduced by 50% (postoperative EROA 0.7 cm2). She remained stable under continuous inotropic support with no other episodes of right ventricular decompensation and was successfully transplanted 30 days after the clipping procedure. Transcatheter treatment of tricuspid regurgitation in a patient with LVAD was an effective strategy to gain time and bridge the patient to heart transplantation.https://doi.org/10.1002/ehf2.12577Transcatheter tricuspid repairLeft ventricle assist deviceTricuspid regurgitationRight ventricle failure
spellingShingle Martin Andreas
Marco Russo
Paul Werner
Matthias Schneider
Franziska Wittmann
Sabine Scherzer
Julia Mascherbauer
Alfred Kocher
Guenther Laufer
Dominik Wiedemann
Daniel Zimpfer
Transcatheter edge‐to‐edge tricuspid repair for recurrence of valvular regurgitation after left ventricular assist device and tricuspid ring implantation
ESC Heart Failure
Transcatheter tricuspid repair
Left ventricle assist device
Tricuspid regurgitation
Right ventricle failure
title Transcatheter edge‐to‐edge tricuspid repair for recurrence of valvular regurgitation after left ventricular assist device and tricuspid ring implantation
title_full Transcatheter edge‐to‐edge tricuspid repair for recurrence of valvular regurgitation after left ventricular assist device and tricuspid ring implantation
title_fullStr Transcatheter edge‐to‐edge tricuspid repair for recurrence of valvular regurgitation after left ventricular assist device and tricuspid ring implantation
title_full_unstemmed Transcatheter edge‐to‐edge tricuspid repair for recurrence of valvular regurgitation after left ventricular assist device and tricuspid ring implantation
title_short Transcatheter edge‐to‐edge tricuspid repair for recurrence of valvular regurgitation after left ventricular assist device and tricuspid ring implantation
title_sort transcatheter edge to edge tricuspid repair for recurrence of valvular regurgitation after left ventricular assist device and tricuspid ring implantation
topic Transcatheter tricuspid repair
Left ventricle assist device
Tricuspid regurgitation
Right ventricle failure
url https://doi.org/10.1002/ehf2.12577
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