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Bicaval Valve Implantation for Severe Tricuspid Regurgitation: Thinking Outside the Valve Box.

ABSTRACT:

SUBMITTER: Bertrand PB

PROVIDER: S-EPMC8289099 | biostudies-literature | 2019 Dec

REPOSITORIES: biostudies-literature

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Bicaval Valve Implantation for Severe Tricuspid Regurgitation: Thinking Outside the Valve Box.

Bertrand Philippe B PB Hung Judy J

JACC. Case reports 20191218 5

PMID: 34316919

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Novel treatment of atrial functional tricuspid regurgitation using transcatheter bicaval valve implantation (TricValve).

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Multimodality Imaging for Evaluation of Bicaval Valved Stent Implantation in Severe Tricuspid Regurgitation.

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Project description:The transcatheter bicaval valve system is an emerging therapeutic option for tricuspid regurgitation, consisting of 2 biological valves to prevent caval reflux. The experience with this device is still scarce, and to the best of our knowledge, this is the first case of thrombosis ever reported. (Level of Difficulty: Advanced.).

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Caval Valve Implantation (CAVI): An Emerging Therapy for Treating Severe Tricuspid Regurgitation.

Project description:Severe tricuspid regurgitation remains a challenging heart-valve disease to effectively treat with high morbidity and mortality at mid-term. Currently guideline-directed medical treatment is limited to escalating dose of diuretics, and the rationale and timing of open-heart surgery remains controversial. Emerging percutaneous therapies for severe tricuspid regurgitation continue to show promising results in early feasibility studies. However, randomized trial data is lacking. Additionally, many patients are deemed unsuitable for these emerging therapies due to anatomical or imaging constraints. Given the technical simplicity of the bicaval valve implantation (CAVI) technique compared to other transcatheter devices, CAVI is postulated as a suitable alternative for a wide variety of patients affected with severe+ tricuspid regurgitation. In this review we illustrate the current evidence and ongoing uncertainties of CAVI, focusing on the novel CAVI-specific devices.

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Heterotopic caval valve implantation for the management of severe tricuspid regurgitation: a case series.

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Project description:Due to progressive abdominal-venous congestion severe tricuspid regurgitation (TR) is a common cause of cardiorenal and cardiohepatic syndrome. We initiated the TRICAVAL study to compare interventional valve implantation into the inferior vena cava (CAVI) versus optimal medical therapy (OMT) in severe TR. In the present subanalysis, we aimed to evaluate the effects of CAVI on clinical signs of congestion, renal and hepatic function. TRICAVAL was an investigator-initiated, randomized trial. Twenty-eight patients with severe TR were randomized to OMT or CAVI using an Edwards Sapien XT valve. Probands who completed the 3-month follow-up (CAVI [n = 8], OMT [n = 10]) were evaluated by medical history, clinical examination, and laboratory testing at baseline, 3 and 12 months. After 3 months, the CAVI group exhibited a significant reduction of body weight (from 80.7 [69.0-87.7] kg to 75.5 [63.8-84.6] kg, p < 0.05) and abdominal circumference (from 101.5 ± 13.8 cm to 96.3 ± 15.4 cm, p ≤ 0.01) and a trend to lower doses of diuretics compared to OMT. Renal and hepatic function parameters did not change significantly. Within a short-term follow-up, CAVI led to an improvement of clinical signs of venous congestion and a non-significant reduction of diuretic doses compared to OMT.

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