Kecskeméti Dorottya, Nagy Zsolt, Temesvári András, Bálint Olga Hajnalka, Fontos Géza, Andréka Péter
1 Gottsegen György Országos Kardiovaszkuláris Intézet Budapest, Haller u. 29., 1096 Magyarország.
2 Semmelweis Egyetem, Doktori Iskola Budapest Magyarország.
Orv Hetil. 2025 Aug 10;166(32):1271-1277. doi: 10.1556/650.2025.33360.
Severe, symptomatic tricuspid regurgitation is a progressive disease with poor prognosis and limited treatment options. TricValve (bicaval, heterotopic valve system) implantation is a new palliative treatment option. The stented bioprosthesis are implanted in the inferior and superior caval veins without interveniening with the native tricuspid valve. We would like to present the first TricValve implantation in Hungary. The 74-year-old woman was admitted for decompensation after repeted hospitalization for right-sided heart failure due to severe secondary tricuspid regurgitation. On admission, she was in NYHA IV functional class with significant fluid retention. On echocardiogram, left ventricular ejection fraction was preserved with signs of right ventricle volume overload and a non-coapting tricuspid valve regurgitation severe regurgitation. Tricuspid valve replacement was indicated, however, the Heart Team contraindicated any surgeries due to the high risk of mortality. The anatomy of the tricuspid valve was not suitable for percutaneous interventions either, however, the anatomy of the caval veins was suitable for TricValve implantation. The valve implantation underwent in a relatively compensated state without any complications. After cardiac rehabilitation, the patient was in NYHA II functional class, the diuretic need was lowered significantly and in the following year no hospitalisation was needed. TricValve implantation can be a solution for patients with severe tricuspid regurgitation if medical treatment is insufficient and surgical and percutaneous valve repair is contraindicated. The implanted cavals valves reduce the reverse venous flow, therefore congestion and symptoms are reduced. To the best of our knowledge, this new procedure can be an adequate palliative treatment, however, long-term survival data are not available yet. Orv Hetil. 2025; 166(32): 1270–1277.
重度有症状三尖瓣反流是一种进行性疾病，预后较差且治疗选择有限。TricValve（双腔、异位瓣膜系统）植入是一种新的姑息治疗选择。带支架的生物假体植入下腔静脉和上腔静脉，而不干预天然三尖瓣。我们想介绍匈牙利首例TricValve植入手术。一名74岁女性因重度继发性三尖瓣反流导致右侧心力衰竭反复住院后，因失代偿入院。入院时，她处于纽约心脏协会（NYHA）心功能IV级，有明显的液体潴留。超声心动图显示，左心室射血分数保留，但有右心室容量超负荷迹象，三尖瓣反流严重且瓣膜不能对合。本应进行三尖瓣置换，但心脏团队因手术死亡率高而禁忌任何手术。三尖瓣的解剖结构也不适合经皮介入，但腔静脉的解剖结构适合TricValve植入。瓣膜植入在相对代偿状态下进行，无任何并发症。心脏康复后，患者处于NYHA心功能II级，利尿剂需求显著降低，次年无需住院。如果药物治疗不足且手术和经皮瓣膜修复禁忌，TricValve植入可为重度三尖瓣反流患者提供一种解决方案。植入的腔静脉瓣膜可减少静脉逆流，从而减轻充血和症状。据我们所知，这种新手术可能是一种合适的姑息治疗方法，但尚无长期生存数据。《匈牙利医学周报》。2025年；166(32):1270–1277。
