An 83-year-old woman with multiple comorbidities and severe aortic stenosis presented with recurrent pulmonary edema. In light of her high surgical risk, a percutaneous strategy for her aortic stenosis was decided. Transcatheter aortic valve replacement using a balloon-expandable Edwards Sapien XT valve was performed under rapid ventricular pacing. Soon after valve deployment, the patient went into hemodynamic collapse due to annular root rupture with pericardial tamponade, necessitating urgent pericardial decompression. Using a valve-in-valve technique, with the deployment of a second Edward Sapien XT valve inside the first valve, the annular root rupture was successfully sealed leading to hemodynamic recovery. (+info)
Is a rigid tricuspid annuloplasty ring superior to a flexible band when correcting secondary tricuspid regurgitation?
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A modified tricuspid valve annuloplasty technique for functional tricuspid regurgitation.
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BACKGROUND: Functional tricuspid regurgitation often occurs in patients with concomitant left sided, valve disease. Several types of tricuspid valve annuloplasty have been described, but there is no consensus on the management of functional tricuspid regurgitation. We report a modified annuloplasty technique and compare its efficacy with the conventional Kay technique. METHODS: A retrospective review was made of 60 patients who received tricuspid valve annuloplasty (group A, modified method; group B, Kay technique) and the early and midterm outcomes of modified method and Kay technique were compared. RESULTS: Three patients underwent ring annuloplasty using a semirigid Carpentier-Edwards ring due to failing suture annuloplasty. All patients were completely cured when they left the hospital. The follow-up time was (32 +/- 7) months in group A and (30 +/- 7) months in group B. After three years, tricuspid regurgitation decreased by more than two grades in 13 patients in group A and 11 in group B. The mean postoperative regurgitation grade in group A was lower than group B at 12, 24 and 36 months but not significantly. Three of 28 patients developed recurrent tricuspid regurgitation in group A and five of 26 patients in group B during the follow-up period (three deaths and three ring annuloplasties excluded). Freedom from recurrent tricuspid regurgitation in group A was higher than that group B at all follow-up points. Postoperative right atrium diameter, right ventricle endodiastolic dimension and tricuspid regurgitation area decreased obviously in both groups. The right ventricle endodiastolic dimension and tricuspid regurgitation area improved more significantly in group A than group B over three years of follow-up, CONCLUSIONS: The modified annuloplasty technique achieved the same outcomes as the conventional Kay annuloplasty over the first three years postoperation. As this modified technique is simple and less expensive, it is another option for correction of functional tricuspid regurgitation. (+info)
Functional annulus remodelling using a prosthetic ring in tricuspid aortic valve repair: mid-term results.
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De Vega annuloplasty for functional tricupsid regurgitation: concept of tricuspid valve orifice index to optimize tricuspid valve annular reduction.
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