Genske Florian, Marquetand Christoph, Eitel Ingo, Frerker Christian, Schmidt Tobias
Medical Clinic II, University Hospital Schleswig-Holstein, University Heart Center Lübeck, Ratzeburger Allee 160, Lübeck 23538, Germany.
DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg/Kiel/Lübeck, Ratzeburger Allee 160, Lübeck, Germany.
Eur Heart J Case Rep. 2025 Feb 11;9(2):ytaf066. doi: 10.1093/ehjcr/ytaf066. eCollection 2025 Feb.
Tricuspid regurgitation (TR) is a disease with significant morbidity and mortality rates. Besides surgery and transcatheter edge-to-edge repair (TEER), transcatheter tricuspid valve replacement has evolved as a possible treatment option in high-risk patients with an unfavourable anatomy for TEER.
We present a case of an 82-year-old patient with torrential TR due to an annulus dilation and subsequent central gap of >8 mm. Echocardiographic guiding was impeded by the presence of two permanent right ventricular implantable cardioverter-defibrillator (ICD) leads and previous surgical aortic valve implantation and mitral valve reconstruction. An EVOQUE prosthesis (Edwards Lifesciences; Irvine, USA) was successfully implanted without impairment of the ICD function or significant paravalvular leakage.
Transcatheter tricuspid valve replacement with the EVOQUE-tricuspid valve replacement system is feasible even in patients with two right ventricular ICD leads and limited echocardiographic visibility.
三尖瓣反流(TR)是一种具有较高发病率和死亡率的疾病。除了手术和经导管缘对缘修复(TEER)外,经导管三尖瓣置换术已发展成为一种针对解剖结构不利于TEER的高危患者的可能治疗选择。
我们报告一例82岁患者,因瓣环扩张导致严重TR,随后中央间隙>8 mm。由于存在两根永久性右心室植入式心脏复律除颤器(ICD)导线以及既往外科主动脉瓣植入和二尖瓣重建,超声心动图引导受到阻碍。成功植入了EVOQUE人工瓣膜(爱德华生命科学公司;美国尔湾),未损害ICD功能或出现明显瓣周漏。
即使对于有两根右心室ICD导线且超声心动图可见度有限的患者,使用EVOQUE三尖瓣置换系统进行经导管三尖瓣置换术也是可行的。