Transcatheter Tricuspid Valve-in-Valve Intervention for Degenerative Bioprosthetic Tricuspid Valve Disease

Isolated reoperative tricuspid valve replacement is one of the highest risk operations classified in the Society of Thoracic Surgeons registry, particularly in the setting of preexisting right ventricular dysfunction. Transcatheter tricuspid valve-in-valve implantation represents an attractive alternative to redo surgery in patients with tricuspid bioprosthetic valve degeneration who are considered high-risk or unsuitable surgical candidates. In this review article, the authors discuss the emergence of transcatheter tricuspid valve-in-valve therapy, preprocedural echocardiographic assessment of tricuspid bioprosthetic valve dysfunction, periprocedural imaging required for tricuspid valve-in-valve implantation, and postprocedural assessment of tricuspid transcatheter device function. •This review article describes the emergence of transcatheter tricuspid valve-in-valve procedures for a failing tricuspid bioprosthesis.•Preprocedural assessment of degenerative tricuspid valve bioprostheses using transthoracic echocardiography is described.•A step-by-step guide to the transesophageal images required for successful transcatheter tricuspid valve-in-valve implantation is described.•The article concludes with a comprehensive review of postprocedural transthoracic follow-up imaging.