Balloon Valvuloplasty for Bioprosthetic Tricuspid Valve Stenosis

A 73-year-old woman was admitted to our hospital for a scheduled percutaneous transcatheter balloon valvuloplasty of a stenotic tricuspid bioprosthesis. The patient had a history consistent with exertional dyspnea, abdominal distension, and edema of the lower extremities resistant to diuretic treatment over the previous few months. Forty-three years prior, she underwent aortic valve replacement with a Starr-Edwards mechanical prosthetic valve, with a mean pressure gradient of 25 mm Hg, for aortic stenosis of rheumatic etiology (Fig. 1, white arrow). Furthermore, three years after aortic valve replacement the patient underwent mitral valve replacement with a bileaflet mechanical valve for mitral stenosis which had a stenotic portion (mean pressure gradient 10 mm Hg) (Fig. 1, black arrow), and tricuspid valve replacement with a CarpentierEdwards bioprosthesis for tricuspid stenosis (Fig. 1, yellow arrow). Images in Cardiovascular Medicine