Barbieri Fabian, Schröder Mark, Beyhoff Niklas, Landmesser Ulf, Reinthaler Markus, Kasner Mario
Department of Cardiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Campus Benjamin Franklin, 12203 Berlin, Germany.
Institute of Active Polymers and Berlin-Brandenburg Center for Regenerative Therapies, Helmholtz-Zentrum Hereon, 14513 Teltow, Germany.
J Cardiovasc Dev Dis. 2021 Sep 14;8(9):111. doi: 10.3390/jcdd8090111.
Tricuspid regurgitation is gaining importance due to its high morbidity and mortality. Especially in the elderly, novel technologies in percutaneous therapies have become valuable options due to the commonly present high surgical risk.
We report a case of a 78-year-old female suffering from massive tricuspid regurgitation with repetitive right-sided heart failure hospitalizations. As the patient was very frail and deemed as high surgical risk, we used the TriClip system to improve her symptomatic status. During diagnostic work-up, an additional membrane separating the right atrium, consistent with the definition of a cor triatriatum dexter, was found. Although increasing the complexity of the procedure, implantation of 3 clips with reduction of tricuspid regurgitation to a mild-to-moderate degree was achieved without any notable complications. The patient was discharged with ameliorated symptoms on the fourth postoperative day.
Our case highlights the feasibility of percutaneous edge-to-edge tricuspid valve repair in an elderly woman with cor triatriatum dexter. Accurate echocardiographic visualization is an absolute requirement to gain access to the tricuspid valve without interacting with prevailing additional membranes.
三尖瓣反流因其高发病率和死亡率而日益受到重视。特别是在老年人中，由于通常存在较高的手术风险，经皮治疗新技术已成为有价值的选择。
我们报告一例78岁女性，患有大量三尖瓣反流，反复因右侧心力衰竭住院。由于患者非常虚弱且被认为手术风险高，我们使用TriClip系统改善其症状状态。在诊断检查期间，发现一个额外的膜将右心房分隔开，符合右房三房心的定义。尽管增加了手术的复杂性，但成功植入3个夹子，将三尖瓣反流减少到轻度至中度，且无任何明显并发症。患者术后第四天症状改善出院。
我们的病例强调了在患有右房三房心的老年女性中进行经皮三尖瓣缘对缘修复的可行性。准确的超声心动图可视化是在不与主要额外膜相互作用的情况下进入三尖瓣的绝对必要条件。
