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Войти в исследования JACC. Case reports · 2026
Transcatheter Tricuspid Valve Replacement for Severe Tricuspid Regurgitation Post-Left Ventricular Assist Device.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
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Giustino Gennaro, Naguib Mostafa, Asselin Chantal Y, Koulogiannis Konstantinos P, Flores Raul, Ahmad Saad, Slater James, Gillam Linda, Généreux Philippe, Singh Abhishek
Аннотация
BACKGROUND: The presence of severe tricuspid regurgitation (TR) in patients supported with durable left ventricular assist devices (LVADs) is associated with increased morbidity and mortality. The role of transcatheter interventions remains limited, but represents a promising therapeutic frontier.
CASE SUMMARY: A 62-year-old woman with chemotherapy-induced cardiomyopathy underwent HeartMate 3 LVAD implantation, complicated by progressive right ventricular (RV) dilation, severe annular dilation, and torrential secondary TR with marked leaflet malcoaptation. Despite guideline-directed medical therapy and chronic inotropic support, she developed refractory RV failure with a ventricularized right atrial waveform on catheterization. Given prohibitive surgical risk, transfemoral transcatheter tricuspid valve replacement (TTVR) with a 56-mm Edwards EVOQUE valve was performed, resulting in near-complete TR elimination, improved RV-pulmonary artery coupling, and clinical recovery.
DISCUSSION: This case illustrates TTVR as a viable therapy for refractory TR and RV failure in select LVAD-supported patients.
TAKE-HOME MESSAGE: TTVR offers a definitive alternative for post-LVAD severe TR when surgical repair is not feasible.
CASE SUMMARY: A 62-year-old woman with chemotherapy-induced cardiomyopathy underwent HeartMate 3 LVAD implantation, complicated by progressive right ventricular (RV) dilation, severe annular dilation, and torrential secondary TR with marked leaflet malcoaptation. Despite guideline-directed medical therapy and chronic inotropic support, she developed refractory RV failure with a ventricularized right atrial waveform on catheterization. Given prohibitive surgical risk, transfemoral transcatheter tricuspid valve replacement (TTVR) with a 56-mm Edwards EVOQUE valve was performed, resulting in near-complete TR elimination, improved RV-pulmonary artery coupling, and clinical recovery.
DISCUSSION: This case illustrates TTVR as a viable therapy for refractory TR and RV failure in select LVAD-supported patients.
TAKE-HOME MESSAGE: TTVR offers a definitive alternative for post-LVAD severe TR when surgical repair is not feasible.