Heterotopic caval valve implantation for the management of severe tricuspid regurgitation: a case series

Aidan Sharkey*, Ronny Munoz Acuna, Kiran Belani, Ravi K. Sharma, Omar Chaudhary, Huma Fatima, Roger Laham, Feroze Mahmood

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Severe tricuspid regurgitation (TR) is a complex condition that can be difficult to treat medically, and often surgical intervention is prohibited due to the high morbidity and mortality associated with this intervention. In patients who have failed maximal medical therapy and have progressive symptoms related to their severe TR, heterotopic caval valve implantation (CAVI) offers potential for symptom relief for these patients. Case summary: We present two cases of patients with severe TR with symptoms of heart failure that were refractory to medical therapy. Due to extensive comorbidities in these patient's surgical intervention was deemed unsuitable and the decision was made to proceed with heterotopic CAVI in order to try and control their symptoms. Both patients successfully underwent the procedure and had an Edwards SAPIEN 3 valve (Edwards Lifesciences, Irvine, CA, USA) implanted in the inferior vena cava/right atrium junction. In both patients, there was improvement in the postoperative haemodynamics as measured by invasive and non-invasive methods. Successful discharge was achieved in both patients with improvement in their symptoms. Discussion: Selective use of heterotopic CAVI to treat symptomatic severe TR that is refractory to medical therapy may be a viable option to improve symptoms in those patients that are unsuitable for surgical intervention.

Original languageEnglish (US)
Article numberytaa428
JournalEuropean Heart Journal - Case Reports
Issue number1
StatePublished - Jan 1 2021


  • case series
  • Caval valve implantation
  • Heart failure
  • Percutaneous intervention
  • Tricuspid regurgitation
  • Valvular heart disease

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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