Tricuspid Regurgitation After Cardiac Transplantation: An Old Problem Revisited

Cardiac Surgery after Heart Transplantation - Elective Operation or Last Exit Strategy?

“…There exist several pathologies of TR that are typical for HTx patients: biopsy-induced injury of the chordae or leaflet, ischemic damage of papillary muscle, or structural distortion of atrial geometry due to implantation technique. 4,7,41 Incidence of severe TR with indication for surgery was significantly lower at our center compared with other centers (0.21% vs 1.7%-5.8%), 5 and none of our patients showed biopsy-induced pathology. Since 1991, our center routinely performs 7 to 8 routine biopsies in the first year after HTx and thereafter only when clinically indicated.…”

“…2,[4][5][6][7][8][9][10][11][12][13] There are only case reports on mitral and aortic valve surgery showing that it seems to be safe in selected patients. 2,5,[14][15][16][17][18][19] New treatment options for these valves with transcatheter aortic valve implantation (TAVI) or MitraClip have been described in case reports, but the benefit of these developments in the field of HTx patients needs to be proven.…”

Tricuspid valve regurgitation after heart transplantation

“…Tricuspid valve regurgitation (TVR) in the donor allograft is the most common valvular complication following heart transplantation with a reported incidence of up to 84% (1). This high rate likely reflects a liberal application of the diagnosis towards a dynamic process that has many etiologies, ranges of severity, and clinical significance.…”

Is the Internal Jugular Vein or Femoral Vein a Better Approach Site for Endomyocardial Biopsy in Heart Transplant Recipients?

“…EMB is consistently reported to be the single most important contributor to significant tricuspid regurgitation due to its anatomic disruption of the tricuspid valvular structure. 14,15) When the bioptome is not directed toward the IVS in the FV approach, the tip of the bioptome may reach the chortae tendineae of the tricuspid valve ( Figure 1B). Approach site selection in the real world: Which approach site is better for successful EMB?…”