Official reprint from UpToDate®
www.uptodate.com ©2017 UpToDate, Inc. and/or its affiliates. All Rights Reserved.

Medline ® Abstract for Reference 43

of 'Management and prognosis of tricuspid regurgitation'

Tricuspid valve and percutaneous approach: No longer the forgotten valve!
Bouleti C, Juliard JM, Himbert D, Iung B, Brochet E, Urena M, Dilly MP, Ou P, Nataf P, Vahanian A
Arch Cardiovasc Dis. 2016;109(1):55. Epub 2015 Nov 12.
Tricuspid valve disease is mainly represented by tricuspid regurgitation (TR), which is a predictor of poor outcome. TR is usually secondary, caused by right ventricle pressure or volume overload, the leading cause being left-sided heart valve diseases. Tricuspid surgery for severe TR is recommended during left valve surgery, and consists of either a valve replacement or, most often, a tricuspid repair with or without prosthetic annuloplasty. When TR persists or worsens after left valvular surgery, redo isolated tricuspid surgery is associated with high mortality. In addition, a sizeable proportion of patients present with tricuspid surgery deterioration over time, and need a reintervention, which is associated with high morbi-mortality rates. In this context, and given the recent major breakthrough in the percutaneous treatment of aortic and mitral valve diseases, the tricuspid valve appears an appealing challenge, although it raises specific issues. The first applications of transcatheter techniques for tricuspid valve disease were valve-in-valve and valve-in-ring implantation for degenerated bioprosthesis or ring annuloplasty. Some concerns remain regarding prosthesis sizing, rapid ventricular pacing and the best approach, but these procedures appear to be safe and effective. More recently, bicuspidization using a transcatheter approach for the treatment of native tricuspid valve has been published, in two patients. Finally, other devices are in preclinical development.
Department of Cardiology, AP-HP, Bichat Hospital, Paris, France; Facultéde Médecine, Paris-Diderot University, Paris, France; DHU Fire, Paris-Diderot University, Paris, France. Electronic address: claire.bouleti@gmail.com.