{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:18:19Z","timestamp":1787008699055,"version":"build-2736575974"},"reference-count":3,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2020,5,4]],"date-time":"2020-05-04T00:00:00Z","timestamp":1588550400000},"content-version":"vor","delay-in-days":1,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>We present a complex case of a failing tricuspid mechanical valve prosthesis in a patient with refractory cardiogenic shock at prohibitive risk for surgery in whom balloon \u2018valvuloplasty\u2019 resulted in immediate haemodynamic improvement in valve function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case summary<\/jats:title>\n                    <jats:p>A 67-year-old woman with remote history of endocarditis s\/p tricuspid valve repair and mechanical aortic valve replacement was referred for second opinion and management of new severe symptomatic tricuspid valve stenosis resulting in progressive debilitating congestive heart failure (HF). The patient was approved by the heart team to undergo redo open heart for surgical repair of the tricuspid valve. Intraoperative technical challenges were met to repair the tricuspid valve. In turn, the native valve was resected and a 33\u2009mm On-X mechanical valve prosthesis. The patient\u2019s post-operative course was complicated by recurrent haemoptysis, prolonged mechanical respiratory support, acute kidney injury, and cardiogenic shock. Surgical re-exploration to address the dysfunctional mechanical tricuspid valve was felt to be prohibitive. Structural heart team was consulted. Cardiac catheterization was recommended to ascertain and confirm findings. The patient was transferred to the cardiac catheterization laboratory. Initial fluoroscopic examination of the heart confirmed the echocardiographic results of an immobile septal leaflet of the recently implanted mechanical tricuspid valve. An 8 \u00d7 40 mm Mustang OTW angioplasty balloon was then advanced across the mechanical valve and inflated gradually at nominal pressure. A single inflation resulted in successful restoration of valve leaflet function.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>To the best of our knowledge, this is the first balloon \u2018valvuloplasty\u2019 on a mechanical On-X valve in the tricuspid position.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytaa086","type":"journal-article","created":{"date-parts":[[2020,5,3]],"date-time":"2020-05-03T16:48:41Z","timestamp":1588524521000},"page":"1-4","source":"Crossref","is-referenced-by-count":3,"title":["Mechanical tricuspid balloon \u2018valvuloplasty\u2019 in a prohibitive risk patient with cardiogenic shock: a case report"],"prefix":"10.1093","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4584-2207","authenticated-orcid":false,"given":"Nader","family":"Hanna","sequence":"first","affiliation":[{"name":"Cleveland Clinic Florida, 2590 Cleveland Clinic Boulevard, Desk 23\/24, Weston, FL 33331, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3576-3660","authenticated-orcid":false,"given":"Andres","family":"Carmona","sequence":"first","affiliation":[{"name":"Cleveland Clinic Florida, 2590 Cleveland Clinic Boulevard, Desk 23\/24, Weston, FL 33331, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hector","family":"Crespo","sequence":"first","affiliation":[{"name":"Cleveland Clinic Florida, 2590 Cleveland Clinic Boulevard, Desk 23\/24, Weston, FL 33331, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto J","family":"Cubeddu","sequence":"first","affiliation":[{"name":"Cleveland Clinic Florida, 2590 Cleveland Clinic Boulevard, Desk 23\/24, Weston, FL 33331, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2020,5,3]]},"reference":[{"key":"2020062620243730100_ytaa086-B1","first-page":"e521","article-title":"AHA\/ACC Guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology\/American Heart Association Task Force on Practice Guidelines","volume":"129","author":"Nishimura","year":"2014","journal-title":"Circulation"},{"key":"2020062620243730100_ytaa086-B2","first-page":"646","article-title":"Balloon \u2018Valvuloplasty\u2019 for mechanical valve dysfunction","volume":"17","author":"Kandzari","year":"1991","journal-title":"J Am Coll Cardiol"},{"key":"2020062620243730100_ytaa086-B3","doi-asserted-by":"crossref","first-page":"e2122","DOI":"10.4244\/EIJ-D-17-00832","article-title":"Thrombosed mechanical tricuspid valve: emergent valvuloplasty as rescue","volume":"13","author":"Goel","year":"2018","journal-title":"EuroIntervention"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/4\/3\/1\/33434320\/ytaa086.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/ehjcr\/article-pdf\/4\/3\/1\/33434320\/ytaa086.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,6,27]],"date-time":"2020-06-27T04:08:03Z","timestamp":1593230883000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/4\/3\/1\/5828465"}},"subtitle":[],"editor":[{"given":"Francesco","family":"Giannini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Suzan","family":"Hatipoglu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Shehab","family":"Anwer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Rahul","family":"Mukherjee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Peregrine","family":"Green","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2020,5,3]]},"references-count":3,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,5,3]]},"published-print":{"date-parts":[[2020,6,1]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytaa086","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,6]]},"published":{"date-parts":[[2020,5,3]]}}}