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Transcatheter tricuspid and mitral valve replacement is a treatment for patients with moderate to severe regurgitation. Regurgitation is the name for leaking heart valves.
A leaking mitral valve allows blood to flow in two directions during the contraction of the heart. Some blood flows from the ventricle through the aortic valve. This is normal. It's when some blood flows back into the atrium through the defective mitral valve each time the left ventricle contracts that you have a problem.
A leaking tricuspid valve is when the right ventricle contracts to pump blood forward to the lungs, and some blood leaks backward into the right atrium. This increases the volume of blood in the atrium. As a result, the right atrium can enlarge. This changes the pressure in the nearby heart chambers and blood vessels.
A replacement valve is a self-expanding stent with an integrated tissue valve. The tissue is expanded directly into the mitral or tricuspid valve to stop the backflow of blood. The inner stent houses the valve for maintaining blood flow. The outer stent secures the implant within the diseased valve. This reduces the need for additional sutures or tethers. The new valve can be inserted from the femoral vein with a catheter. This is a less invasive, and less dangerous, procedure than open heart surgery.
Presbyterian Heart and Vascular Care has a team of highly-skilled surgeons who are using some of the most advanced techniques to perform this procedure. These techniques can improve recovery time, reduce complications and provide a quicker return to work and other daily activities.
Patients who have valve stenosis, an enlarged atrium, pulmonary hypertension, or who are at risk for traditional open-heart surgery may be eligible for this replacement procedure. To determine whether valve replacement is appropriate, patients will be evaluated with tests that include:
Mitral and tricuspid valve replacement treats regurgitation, a common valvular heart disease, or mitral stenosis. People with regurgitation may experience:
The underlying cause of regurgitation is often pulmonary hypertension, either from left-sided heart failure, mitral or aortic valve disease, or primary pulmonary causes. Atrial fibrillation may be both a sign of the disease getting worse.
As you prepare for the surgery, you and your healthcare provider will decide what kind of valve will work best for you. Your surgeon will replace your valve with a biological valve or a mechanical valve.
Remember the following:
About an hour before the operation, someone will give you medicines to help you relax. In most cases, your surgery will proceed as planned, but sometimes another emergency might delay your operation.
The procedure is performed using one of several approaches. The two most common approaches are:
During the procedure:
After the procedure:
You will probably have your stitches or staples removed in a follow-up appointment in seven to ten days. Be sure to keep all follow-up appointments. It may be several weeks before you fully recover.
At home, take your temperature and your weight every day. Tell your doctor if your temperature is over 100.4°F (38°C), or if your weight changes. Ask when it is safe for you to drive. Avoid lifting anything heavy for several weeks. Ask your healthcare provider about what is safe for you to lift. Follow all the instructions your healthcare provider gives you for medicines, exercise, diet, and wound care.
Make sure all your dentists and other healthcare providers know about your medical history. You may need to take antibiotics before certain medical and dental procedures to prevent getting an infection on your replacement valve.
Patients who receive a mechanical valve will require a blood-thinning medication for the rest of their lives. The blood thinner will keep clots from forming.