Journal article
1-Year Outcomes After Edge-to-Edge Valve Repair for Symptomatic Tricuspid Regurgitation: Results From the TriValve Registry.
- Mehr M Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany; German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany.
- Taramasso M Department of Cardiovascular Surgery, University Hospital of Zürich, University of Zürich, Zürich, Switzerland.
- Besler C Leipzig Heart Center, University of Leipzig, Leipzig, Germany.
- Ruf T Mainz University Hospital, University of Mainz, Mainz, Germany.
- Connelly KA Division of Cardiology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
- Weber M Bonn University Hospital, University of Bonn, Bonn, Germany.
- Yzeiraj E Albertinen Heart Center, Hamburg, Germany.
- Schiavi D San Raffaele University Hospital, Milan, Italy.
- Mangieri A San Raffaele University Hospital, Milan, Italy.
- Vaskelyte L CardioVascular Center, Frankfurt, Germany.
- Alessandrini H Asklepios Klinik St. Georg, Hamburg, Germany.
- Deuschl F University Heart Center Hamburg, University of Hamburg, Hamburg, Germany.
- Brugger N Inselspital, University of Bern, Bern, Switzerland.
- Ahmad H Westchester Medical Center, Valhalla, New York.
- Biasco L CardioCentro Ticino, Lugano, Switzerland.
- Orban M Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany; German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany.
- Deseive S Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany; German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany.
- Braun D Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany; German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany.
- Rommel KP Leipzig Heart Center, University of Leipzig, Leipzig, Germany.
- Pozzoli A Department of Cardiovascular Surgery, University Hospital of Zürich, University of Zürich, Zürich, Switzerland.
- Frerker C Asklepios Klinik St. Georg, Hamburg, Germany.
- Näbauer M Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany; German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany.
- Massberg S Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany; German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany.
- Pedrazzini G CardioCentro Ticino, Lugano, Switzerland.
- Tang GHL Westchester Medical Center, Valhalla, New York; Mount Sinai Medical Center, New York, New York.
- Windecker S Inselspital, University of Bern, Bern, Switzerland.
- Schäfer U University Heart Center Hamburg, University of Hamburg, Hamburg, Germany.
- Kuck KH Asklepios Klinik St. Georg, Hamburg, Germany.
- Sievert H CardioVascular Center, Frankfurt, Germany.
- Denti P San Raffaele University Hospital, Milan, Italy.
- Latib A San Raffaele University Hospital, Milan, Italy.
- Schofer J Albertinen Heart Center, Hamburg, Germany.
- Nickenig G Bonn University Hospital, University of Bonn, Bonn, Germany.
- Fam N Division of Cardiology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
- von Bardeleben S Mainz University Hospital, University of Mainz, Mainz, Germany.
- Lurz P Leipzig Heart Center, University of Leipzig, Leipzig, Germany.
- Maisano F Department of Cardiovascular Surgery, University Hospital of Zürich, University of Zürich, Zürich, Switzerland.
- Hausleiter J Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany; German Centre for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany. Electronic address: joerg.hausleiter@med.uni-muenchen.de.
- 2019-08-10
Published in:
- JACC. Cardiovascular interventions. - 2019
TR
edge-to-edge repair
heart failure
structural heart disease
tricuspid valve interventional repair
Aged
Aged, 80 and over
Cardiac Catheterization
Compassionate Use Trials
Europe
Female
Heart Valve Prosthesis
Heart Valve Prosthesis Implantation
Hemodynamics
Humans
Male
North America
Recovery of Function
Registries
Retrospective Studies
Risk Factors
Severity of Illness Index
Time Factors
Treatment Outcome
Tricuspid Valve
Tricuspid Valve Insufficiency
English
OBJECTIVES
The purpose of this study was to evaluate procedural and 1-year clinical and echocardiographic outcomes of patients treated with tricuspid edge-to-edge repair.
BACKGROUND
Transcatheter edge-to-edge repair has been successfully performed in selected patients with symptomatic tricuspid regurgitation (TR) and high risk for surgery, but outcome data are sparse.
METHODS
This analysis of the multicenter international TriValve (Transcatheter Tricuspid Valve Therapies) registry included 249 patients with severe TR treated with edge-to-edge repair in compassionate and/or off-label use. Clinical and echocardiographic outcomes were prospectively collected and retrospectively analyzed.
RESULTS
In 249 patients (mean age 77 ± 9 years; European System for Cardiac Operative Risk Evaluation II score 6.4% [interquartile range: 3.9% to 13.9%]), a successful procedure with TR reduction to grade ≤2+ was achieved in 77% by placement of 2 ± 1 tricuspid clips. Concomitant treatment of severe TR and mitral regurgitation was performed in 52% of patients. At 1-year follow-up, significant and durable improvements in TR severity (TR ≤2+ in 72% of patients) and New York Heart Association functional class (≤II in 69% of patients) were observed. All-cause mortality was 20%, and the combined rate of mortality and unplanned hospitalization for heart failure was 35%. Predictors of procedural failure included effective regurgitant orifice area, tricuspid coaptation gap, tricuspid tenting area, and absence of central or anteroseptal TR jet location. Predictors of 1-year mortality were procedural failure, worsening kidney function, and absence of sinus rhythm.
CONCLUSIONS
Transcatheter tricuspid edge-to-edge repair can achieve TR reduction at 1 year, resulting in significant clinical improvement. Predictors of procedural failure and 1-year mortality identified here may help select patients who will benefit most from this therapy.
The purpose of this study was to evaluate procedural and 1-year clinical and echocardiographic outcomes of patients treated with tricuspid edge-to-edge repair.
BACKGROUND
Transcatheter edge-to-edge repair has been successfully performed in selected patients with symptomatic tricuspid regurgitation (TR) and high risk for surgery, but outcome data are sparse.
METHODS
This analysis of the multicenter international TriValve (Transcatheter Tricuspid Valve Therapies) registry included 249 patients with severe TR treated with edge-to-edge repair in compassionate and/or off-label use. Clinical and echocardiographic outcomes were prospectively collected and retrospectively analyzed.
RESULTS
In 249 patients (mean age 77 ± 9 years; European System for Cardiac Operative Risk Evaluation II score 6.4% [interquartile range: 3.9% to 13.9%]), a successful procedure with TR reduction to grade ≤2+ was achieved in 77% by placement of 2 ± 1 tricuspid clips. Concomitant treatment of severe TR and mitral regurgitation was performed in 52% of patients. At 1-year follow-up, significant and durable improvements in TR severity (TR ≤2+ in 72% of patients) and New York Heart Association functional class (≤II in 69% of patients) were observed. All-cause mortality was 20%, and the combined rate of mortality and unplanned hospitalization for heart failure was 35%. Predictors of procedural failure included effective regurgitant orifice area, tricuspid coaptation gap, tricuspid tenting area, and absence of central or anteroseptal TR jet location. Predictors of 1-year mortality were procedural failure, worsening kidney function, and absence of sinus rhythm.
CONCLUSIONS
Transcatheter tricuspid edge-to-edge repair can achieve TR reduction at 1 year, resulting in significant clinical improvement. Predictors of procedural failure and 1-year mortality identified here may help select patients who will benefit most from this therapy.
- Language
-
- English
- Open access status
- bronze
- Identifiers
-
- DOI 10.1016/j.jcin.2019.04.019
- PMID 31395215
- Persistent URL
- https://folia.unifr.ch/global/documents/201782
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