In patient with degenerative tricuspid surgical bioprosthesis, redo tricuspid valve replacement (TVR) remains a major surgery with considerable morbidity and mortality. 1 Transcatheter tricuspid valve-in-valve (ViV) has emerged as a viable treatment option for these patients with encouraging outcomes for both short and mid-term in most patients. [2][3][4][5] These patients usually had variable etiology of original tricuspid valve disease that can be congenital or acquired. 2 The first-in-man tricuspid VIV was reported in 2011 using Edwards SAPIEN valve (Edwards Lifesciences) via internal jugular access. 6 Since then, the tricuspid ViV procedures have gained popularity with transfemoral access being the most popular. 7,8 Reports from the international VIVID registry (Valve-in-Valve International database) demonstrated that TVIV can be performed successfully and safely in most cases. 9 The state-of-the-art review by Sanon et al. has highlighted the proper preprocedural planning, procedure techniques, and principle of tricuspid ViV implantation. 10 The experience has been described mostly in the Western communities. We report our case series of transcatheter tricuspid ViV that performed in Asia, where patients' primary tricuspid valve etiology, comorbidities, and choices of original tricuspid valve surgery may be different. In addition, transcatheter ViV has not yet been

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Hypertrophic cardiomyopathy (HCM) and dilated cardiomyopathy (DCM) are the most common referrals in the Inherited Cardiovascular Condition (ICC) Genetics Service. Several issues must be discussed with patients and their families during the genetic consultation session, including the options for genetic testing and cardiovascular surveillance in family members. We developed an ICC registry and performed next-generation-based DNA sequencing for all patients affected by non-syndromic HCM and idiopathic DCM in our joint specialist genetics service. The target gene sequencing panel relied on the Human Phenotype Ontology with 237 genes for HCM (HP:0001639) and 142 genes for DCM (HP:0001644). All subjects were asked to contact their asymptomatic first-degree relatives for genetic counseling regarding their risks and to initiate cardiovascular surveillance and cascade genetic testing. The study was performed from January 1, 2014, to December 31, 2020, and a total of 62 subjects (31-HCM and 31-DCM) were enrolled. The molecular detection frequency was 48.39% (32.26% pathogenic/likely pathogenic, 16.13% variant of uncertain significance or VUS for HCM, and 25.81% (16.13% pathogenic/likely pathogenic, 9.68% VUS) for DCM. The most prevalent gene associated with HCM was MYBPC3. The others identified in this study included ACTN2, MYL2, MYH7, TNNI3, TPM1, and VCL. Among the DCM subjects, variants were detected in two cases with the TTN nonsense variants, while the others were missense and identified in MYH7, DRSP3, MYBPC3, and SCN5A. Following the echocardiogram surveillance and cascade genetic testing in the asymptomatic first-degree relatives, the detection rate of new cases was 8.82% and 6.25% in relatives of HCM and DCM subjects, respectively. Additionally, a new pre-symptomatic relative belonging to an HCM family was identified, although the genomic finding in the affected case was absent. Thus, ICC service is promising for the national healthcare system, aiming to prevent morbidity and mortality in asymptomatic family members.

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