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Bioprosthetic tricuspid valve stenosis: a case series

BACKGROUND: Bioprosthetic tricuspid valve stenosis is a late sequela of tricuspid valve replacement (TVR); however, detailed information regarding its clinical picture is lacking. CASE SUMMARY: Thirty-one patients with bioprosthetic TVR (mean age: 60.5 ± 16.6 years, male/female: 11/20) were followed...

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Autores principales: Hirata, Kazuhito, Tengan, Toshiho, Wake, Minoru, Takahashi, Takanori, Ishimine, Toru, Yasumoto, Hiroshi, Nakasu, Akio, Mototake, Hidemitsu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6764547/
https://www.ncbi.nlm.nih.gov/pubmed/31367735
http://dx.doi.org/10.1093/ehjcr/ytz110
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author Hirata, Kazuhito
Tengan, Toshiho
Wake, Minoru
Takahashi, Takanori
Ishimine, Toru
Yasumoto, Hiroshi
Nakasu, Akio
Mototake, Hidemitsu
author_facet Hirata, Kazuhito
Tengan, Toshiho
Wake, Minoru
Takahashi, Takanori
Ishimine, Toru
Yasumoto, Hiroshi
Nakasu, Akio
Mototake, Hidemitsu
author_sort Hirata, Kazuhito
collection PubMed
description BACKGROUND: Bioprosthetic tricuspid valve stenosis is a late sequela of tricuspid valve replacement (TVR); however, detailed information regarding its clinical picture is lacking. CASE SUMMARY: Thirty-one patients with bioprosthetic TVR (mean age: 60.5 ± 16.6 years, male/female: 11/20) were followed-up for 79.5 ± 49.1 months (14–188 months). Eleven patients developed bioprosthetic tricuspid valve stenosis (mean tricuspid gradient >5 mmHg) at a median interval of 96 months (interquartile range: 61–114 months). The mean tricuspid gradient at the time of tricuspid valve stenosis diagnosis was 10.9 ± 3.9 mmHg. Although the mid-term tricuspid valve stenosis-free survival was favourable (92.4% at 60 and 78.7% at 84 months), it had declined steeply to 31.5% by 120 months. Ten out of 11 tricuspid valve stenosis patients showed signs of right heart failure (RHF) as manifested by oedema and elevated jugular venous pressure, requiring moderate-to-high doses of diuretics. Diastolic rumble was audible in 10 patients. Five of the 11 tricuspid valve stenosis patients required redo TVR as a result of refractory RHF. Examination of the five excised bioprostheses showed pannus in four, fusion of the commissure in three, native valve attachment in two, and sclerosis in one. Detailed clinical pictures and pathology of the explanted valves in three cases that underwent surgery are presented in this case series. DISCUSSION: Bioprosthetic tricuspid valve stenosis is not uncommon after 8 years. Tricuspid valve replacement performed at the second surgery was associated with a higher incidence of bioprosthetic tricuspid valve stenosis.
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spelling pubmed-67645472019-10-02 Bioprosthetic tricuspid valve stenosis: a case series Hirata, Kazuhito Tengan, Toshiho Wake, Minoru Takahashi, Takanori Ishimine, Toru Yasumoto, Hiroshi Nakasu, Akio Mototake, Hidemitsu Eur Heart J Case Rep Case Series BACKGROUND: Bioprosthetic tricuspid valve stenosis is a late sequela of tricuspid valve replacement (TVR); however, detailed information regarding its clinical picture is lacking. CASE SUMMARY: Thirty-one patients with bioprosthetic TVR (mean age: 60.5 ± 16.6 years, male/female: 11/20) were followed-up for 79.5 ± 49.1 months (14–188 months). Eleven patients developed bioprosthetic tricuspid valve stenosis (mean tricuspid gradient >5 mmHg) at a median interval of 96 months (interquartile range: 61–114 months). The mean tricuspid gradient at the time of tricuspid valve stenosis diagnosis was 10.9 ± 3.9 mmHg. Although the mid-term tricuspid valve stenosis-free survival was favourable (92.4% at 60 and 78.7% at 84 months), it had declined steeply to 31.5% by 120 months. Ten out of 11 tricuspid valve stenosis patients showed signs of right heart failure (RHF) as manifested by oedema and elevated jugular venous pressure, requiring moderate-to-high doses of diuretics. Diastolic rumble was audible in 10 patients. Five of the 11 tricuspid valve stenosis patients required redo TVR as a result of refractory RHF. Examination of the five excised bioprostheses showed pannus in four, fusion of the commissure in three, native valve attachment in two, and sclerosis in one. Detailed clinical pictures and pathology of the explanted valves in three cases that underwent surgery are presented in this case series. DISCUSSION: Bioprosthetic tricuspid valve stenosis is not uncommon after 8 years. Tricuspid valve replacement performed at the second surgery was associated with a higher incidence of bioprosthetic tricuspid valve stenosis. Oxford University Press 2019-07-13 /pmc/articles/PMC6764547/ /pubmed/31367735 http://dx.doi.org/10.1093/ehjcr/ytz110 Text en © The Author(s) 2019. Published by Oxford University Press on behalf of the European Society of Cardiology. http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Case Series
Hirata, Kazuhito
Tengan, Toshiho
Wake, Minoru
Takahashi, Takanori
Ishimine, Toru
Yasumoto, Hiroshi
Nakasu, Akio
Mototake, Hidemitsu
Bioprosthetic tricuspid valve stenosis: a case series
title Bioprosthetic tricuspid valve stenosis: a case series
title_full Bioprosthetic tricuspid valve stenosis: a case series
title_fullStr Bioprosthetic tricuspid valve stenosis: a case series
title_full_unstemmed Bioprosthetic tricuspid valve stenosis: a case series
title_short Bioprosthetic tricuspid valve stenosis: a case series
title_sort bioprosthetic tricuspid valve stenosis: a case series
topic Case Series
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6764547/
https://www.ncbi.nlm.nih.gov/pubmed/31367735
http://dx.doi.org/10.1093/ehjcr/ytz110
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