Structural Heart & Valve Center, New York Presbyterian/Columbia University Medical Center, New York, New York.
Morristown Medical Center, Morristown, New Jersey.
J Am Soc Echocardiogr. 2018 Apr;31(4):491-504. doi: 10.1016/j.echo.2017.06.014. Epub 2017 Aug 23.
Isolated reoperative tricuspid valve replacement is one of the highest risk operations classified in the Society of Thoracic Surgeons registry, particularly in the setting of preexisting right ventricular dysfunction. Transcatheter tricuspid valve-in-valve implantation represents an attractive alternative to redo surgery in patients with tricuspid bioprosthetic valve degeneration who are considered high-risk or unsuitable surgical candidates. In this review article, the authors discuss the emergence of transcatheter tricuspid valve-in-valve therapy, preprocedural echocardiographic assessment of tricuspid bioprosthetic valve dysfunction, periprocedural imaging required for tricuspid valve-in-valve implantation, and postprocedural assessment of tricuspid transcatheter device function.
孤立的再次三尖瓣置换术是胸外科医师协会登记处分类的风险最高的手术之一,尤其是在存在先前存在的右心室功能障碍的情况下。对于三尖瓣生物瓣退行性变且被认为是高危或不适合手术的患者,经导管三尖瓣瓣中瓣植入术是一种有吸引力的再次手术替代方法。在这篇综述文章中,作者讨论了经导管三尖瓣瓣中瓣治疗的出现、三尖瓣生物瓣功能障碍的术前超声心动图评估、经导管三尖瓣瓣中瓣植入所需的围手术期影像学检查以及经导管三尖瓣装置功能的术后评估。