Percutaneous Transcatheter Valve-in-Valve Implantation in Stenosed Tricuspid Valve Bioprosthesis

Transcatheter valve-in-valve implantation is a promising treatment option for degenerated bioprosthetic heart valves in high-risk patients.1 Successful percutaneous techniques have been described for pulmonary and aortic valves.2,3 We present the first successful percutaneous tricuspid valve-in-valve implantation.The patient was a fragile 74-year-old woman with chronic obstructive pulmonary disease (forced expiratory volume in 1 second, 53%), impaired renal function (modified diet in renal disease 35 mL/min/1.73 m2), and cardiac hepatic cirrhosis with ascites and cachexia (body mass index 19 kg/m2), admitted with chronic right-sided heart failure and severe stenosis of a degenerated tricuspid bioprosthesis. Previously, a partial atrioventricular canal defect had been treated in 3 consecutive surgical interventions. During the last procedure, 23 years ago, a mechanical mitral valve replacement (St. Jude 25 mm, SJM, Inc., St. Paul, MN) had been performed, combined with a bioprosthetic tricuspid valve replacement (pericardial Carpentier Edwards …