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Diagnosis and Management of Failed Surgical Tricuspid Valve Annuloplasty

  • Structural Heart Disease (RJ Siegel and NC Wunderlich, Section Editors)
  • Published:
Current Cardiology Reports Aims and scope Submit manuscript

Abstract

Purpose of the Review

Annular-based strategies for treating tricuspid valve (TV) regurgitation do not always have satisfactory long-term outcomes. Management of failed TV annuloplasty can be challenging and requires a dedicated heart team approach. This review explores the treatment options available for failed TV annuloplasty.

Recent findings

Recent developments and novel percutaneous treatment options have emerged as promising alternatives for patients with failed TV annuloplasty. Leaflet-based interventions, valve-in-valve procedures, transcatheter tricuspid valves and new-generation trans-caval valves are all feasible options, which can assure good results whilst minimizing risks for the patient.

Summary

Failure of tricuspid annuloplasty is not uncommon amongst patients treated with either a tricuspid ring or suture-based device. The complex anatomy, physiology and clinical risk profile should be carefully evaluated on an individual patient-by-patient basis in order to select the most appropriate clinical and percutaneous treatment strategy. Different transcatheter tricuspid valve repair or replacement techniques may provide an attractive alternative treatment option for managing this challenging patient cohort.

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Abbreviations

TR:

Tricuspid regurgitation

TV:

Tricuspid valve

CMR:

Cardiac magnetic resonance

CT:

Computed tomography

RV:

Right ventricle

EROA:

Effective regurgitant orifice area

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Author information

Authors and Affiliations

  1. Invasive Cardiology Unit, Humanitas Clinical and Research Center, IRCCS, Alessandro Manzoni, 56, 20089, Rozzano, Milan, Italy

    Antonio Mangieri, Damiano Regazzoli, Bernhard Reimers & Antonio Colombo

  2. Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy

    Antonio Mangieri, Damiano Regazzoli, Bernhard Reimers & Antonio Colombo

  3. Cardiology Unit, ASST Melegnano-Martesana, Milan, Italy

    Alessandra Laricchia

  4. Cardiovascular Department, ASST Santi Paolo e Carlo, Milan, Italy

    Alberto Cereda

  5. GVM Care & Research, Maria Cecilia Hospital, Cotignola, Italy

    Arif A Khokhar & Francesco Giannini

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  1. Antonio Mangieri
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  2. Alessandra Laricchia
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  4. Arif A Khokhar
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Correspondence to Antonio Colombo.

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Conflict of Interest

Antonio Mangieri received an institutional grant from Boston Scientific and is part of the advisory board of the Boston Scientific.

The other authors declare that they have no conflict of interest.

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Mangieri, A., Laricchia, A., Cereda, A. et al. Diagnosis and Management of Failed Surgical Tricuspid Valve Annuloplasty. Curr Cardiol Rep 23, 137 (2021). https://doi.org/10.1007/s11886-021-01569-1

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