Transcatheter interventions spark a paradigm change for management of patients with mixed valve disease
Rebecca T. Hahn, Philippe Pîbarot, Catherine M Otto
Abstract
Transcatheter interventions for valve stenosis and regurgitation offer an alternative approach to management of patients with mixed valvular heart disease. For example, in a younger low-risk patient with severe aortic stenosis (AS), moderate mitral regurgitation (MR), and severe tricuspid regurgitation (TR), the conventional surgical approach of replacing or repairing all three valves during one surgical procedure might be reasonable. However, in an older high-risk patient, or when AS is the most severe lesion with uncertain severity of other valve lesions, a stepwise approach might be considered with transcatheter aortic valve implantation (TAVI), mitral transcatheter edge-to-edge repair (TEER), and a transcatheter tricuspid procedure with a period of time for cardiac remodelling and reassessment after each intervention.