[Treatment of severe tricuspid insufficiency associated with right ventricular dysfunction through the implantation of a transcatheter bi-caval system].

Abstract

Tricuspid regurgitation (TR) is the most common condition of the tricuspid valve. It generally occurs associated with other heart diseases and was previously not considered a target for intervention. It is currently of particular interest because it was demonstrated that severe TR is associated with increased morbidity and mortality. Given the high in-hospital mortality risk of isolated tricuspid valve surgery, the early success of transcatheter repair or replacement techniques has increased access to relatively low-risk procedures. The bi-caval system is a heterotopic valve replacement therapy consisting of two self-expanding valves implanted sequentially in the superior and inferior vena cava via percutaneous access through the femoral vein. We present here the case of a 72-year-old woman with a history of chronic atrial fibrillation, mixed pulmonary hypertension, severe symptomatic TR and right ventricular dysfunction, who received percutaneous treatment with implantation of a bi-caval system associated with hemodynamic and clinic improvements.