Percutaneous tricuspid valve implantation

Since the advent of percutaneous valve implantation in the year 2000, many patients were treated successfully by a percutaneously implanted valve in the aortic and less frequently in the pulmonic position. So far, only a few patients were treated by percutaneous tricuspid valve implantation (PTVI) and even less by percutaneous mitral valve implantation. This current chapter describes PTVI. The initial treatment of severe tricuspid valve dysfunction (regurgitation or stenosis or both) is surgical plasty at our center. Only if a surgical valvuloplasty does not seem feasible or the result of this operation is unsatisfactory, tricuspid valve replacement is performed. However, with elapsing time biological valves undergo degeneration and need to be replaced once valve dysfunction reoccurs. Valve degeneration leads to tricuspid regurgitation and/or stenosis, right atrial enlargement, onset of clinical deterioration, atrial dysrhythmias, and signs of right heart failure. To avoid repeated open heart surgeries and to reduce the number of surgical procedures during a patient life, PTVI is an alternative treatment option. The failing bioprosthesis usually is an ideal “landing zone“ for a percutaneous valve, if the dimensions are well defined.