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Transcatheter Valve-In-Valve Implantation in Patients With Fluoroscopically Invisible Tricuspid Valve Prostheses

Year: 2025

Type: article

Abstract: Tricuspid bioprostheses are prone to structural valve degeneration, often requiring complex interventions. Surgical reoperation carries high morbidity and mortality, whereas transcatheter valve-in-valve implantation offers a safer alternative. However, when the tricuspid prosthesis is fluoroscopically invisible, accurate valve positioning becomes challenging. This case series presents 3 such patients successfully treated using a novel adjunctive technique. A coronary guidewire was positioned in the right coronary artery as an anatomical marker for the atrioventricular groove. Balloon pre-dilatation was then performed to delineate the bioprosthetic valve's position, guiding precise deployment of the new valve. All procedures utilized Myval prostheses and were completed without major complications. Post-procedural echocardiography confirmed optimal valve function, low transvalvular gradients, and no residual regurgitation. This reproducible approach of combining RCA guidewire marking with balloon pre-dilatation offers an accurate, low-risk solution for managing fluoroscopically invisible tricuspid prostheses during valve-in-valve implantation.

Source: JACC Case Reports

DOI: 10.1016/j.jaccas.2025.105920

Authors: Dzhem Farandzha, Nikolay Stoyanov, Vasil Velchev

Institution: Medical University of Sofia

Language: English

Topic: Cardiac Valve Diseases and Treatments

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $850