Right Ventricular Volume Unload: Transcatheter Tricuspid Valve Replacement in Congenital Heart Disease.

BACKGROUND: The population of adults with repaired congenital heart disease is increasing, and given their frequent history of repeated surgeries, they are the ones that may benefit the most from less-invasive therapeutic options, in order to truly address their disease with a lifespan-management perspective. Tetralogy of Fallot patients frequently present with significant tricuspid regurgitation which has been associated with adverse clinical events. CASE SUMMARY: We report hereinafter on a successful transcatheter tricuspid valve replacement (TTVR) in a middle-age Tetralogy of Fallot patient at high surgical risk. Our aim is to emphasize on the technical challenges but also on the major benefits of the procedure, either from a symptomatic or structural remodeling standpoint. DISCUSSION: TTVR represents a promising therapy for this underserved subgroup of patients. TAKE-HOME MESSAGES: TTVR in Tetralogy of Fallot patients is feasible. Despite the frequent advanced and chronic right ventricular adverse remodeling observed in this population, those patients may derive a great benefit from the procedure. Right ventricular reverse remodeling was associated with major symptomatic and functional improvement.