Tricuspid valve-in-valve implantation for failing bioprosthetic valves: an evolving standard of care.

Redo surgery for bioprosthetic tricuspid valve failure is associated with high morbidity and mortality. In recent years, transcatheter tricuspid valve-in-valve (VIV) therapy utilizing ballon-expandable transcatheter valves has become available. The tricuspid Valve-in-Valve International Data (VIVID) registry initial results represent the largest experience with tricuspid VIV therapy, demonstrating high procedural success rates with low 30 days mortality and excellent survival free of repeat tricuspid intervention in 1 year. Although longer clinic and hemodynamic follow-up will be needed to fully understand the role of this therapy, these data support the safety, feasibility and beneficial effects of tricuspid VIV therapy. For patients with bioprosthetic tricuspid valve failure, tricuspid VIV is likely to become a first-line treatment option.