Our Summary

In this research, doctors at the Ahmanson/UCLA Adult Congenital Heart Disease Center looked at cases of patients who had problems with both their tricuspid and pulmonary valves. These are two of the four main valves in the heart, and damage to them can cause serious health problems.

Traditionally, fixing these valves requires open heart surgery, which can be risky. In this study, they used a less invasive procedure called a transcatheter replacement, which involves inserting a new valve through a small tube that’s threaded through the blood vessels.

The research focused on five adult patients, three of whom were born with heart defects and two who developed valve disease due to a condition called carcinoid syndrome. Four of the patients had previously had surgery to replace the tricuspid valve, and all five had had surgery to replace the pulmonary valve.

Two of the patients had a type of valve called a Medtronic Melody implanted, while the other three had a different type called an Edwards Sapien S3. The procedure to implant the new valves was successful in all cases.

The patients were followed up between 0.9 and 3.0 years after the operation. One patient, who had a Medtronic Melody valve, needed another operation a year later due to leaking of the valve and unfortunately passed away 2.5 years after the operation from complications related to heart failure. The other four patients were still alive at the time of the study and had not needed any further operations on their valves.

In conclusion, the researchers found that replacing both the tricuspid and pulmonary valves at the same time using a transcatheter procedure can be successful and has an acceptable risk of complications. Therefore, it could be a good option for patients who are suitable for this type of procedure.

FAQs

  1. What is the risk associated with operative intervention for patients with combined tricuspid and pulmonary valve disease?
  2. What has been the success rate of combined transcatheter tricuspid and pulmonary valve replacement in the study conducted at the Ahmanson/UCLA Adult Congenital Heart Disease Center?
  3. Can combined transcatheter tricuspid and pulmonary valve replacement be a feasible option for all patients with heart valve diseases?

Doctor’s Tip

One helpful tip a doctor might tell a patient about pulmonary valve replacement is to follow up regularly with their healthcare provider to monitor the function of the new valve and address any potential complications early on. It is important for patients to communicate any new symptoms or changes in their condition to their healthcare team promptly. Additionally, maintaining a healthy lifestyle, including regular exercise and a balanced diet, can help support overall heart health and the longevity of the new valve.

Suitable For

Patients who are typically recommended for pulmonary valve replacement are those with congenital heart disease, carcinoid syndrome, previous surgical tricuspid and/or pulmonary valve replacement, and right ventricle-to-pulmonary artery homograft conduit. These patients may experience symptoms such as progressive regurgitation, refractory heart failure, and other complications related to their valve disease. Combined transcatheter tricuspid and pulmonary valve replacement may be considered in these patients as a feasible option for valve intervention.

Timeline

Before pulmonary valve replacement:

  1. The patient is diagnosed with combined tricuspid and pulmonary valve disease.
  2. The patient undergoes evaluation and assessment by a medical team to determine the need for intervention.
  3. The patient may have previous surgical interventions such as tricuspid and/or pulmonary valve replacement.
  4. The patient is selected as a candidate for combined transcatheter tricuspid and pulmonary valve replacement.
  5. The patient undergoes the transcatheter valve replacement procedure.

After pulmonary valve replacement:

  1. The patient undergoes follow-up evaluations and monitoring post-procedure.
  2. The patient may require additional interventions or procedures, such as redo transcatheter tricuspid valve replacement for progressive regurgitation.
  3. The patient experiences improvements in symptoms and cardiac function following valve replacement.
  4. The patient may experience complications related to the procedure, such as refractory heart failure.
  5. The patient continues to be monitored for valve function and overall cardiac health in the long term.

What to Ask Your Doctor

  1. What are the risks and benefits of undergoing a combined transcatheter tricuspid and pulmonary valve replacement procedure?
  2. How long is the recovery time following the procedure?
  3. Will I need to take medication after the procedure, and if so, for how long?
  4. How often will I need follow-up appointments to monitor the function of the new valves?
  5. Are there any lifestyle changes I should make following the procedure to ensure the longevity of the new valves?
  6. What signs or symptoms should I watch for that may indicate a complication with the new valves?
  7. Are there any restrictions on physical activity or exercise following the procedure?
  8. How long do the new valves typically last before needing to be replaced again?
  9. Are there any alternative treatment options to consider instead of a combined transcatheter tricuspid and pulmonary valve replacement?
  10. What is the success rate of this procedure in patients with similar medical history and conditions?

Reference

Authors: Small AJ, Aksoy O, Levi DS, Salem MM, Yang EH, Aboulhosn JA. Journal: World J Pediatr Congenit Heart Surg. 2020 Jul;11(4):432-437. doi: 10.1177/2150135120918777. PMID: 32645786