1-Year Outcomes After Edge-to-Edge Valve Repair for Symptomatic Tricuspid Regurgitation: Results From the TriValve Registry.

Autor:	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 RS; 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.
Jazyk:	angličtina
Zdroj:	JACC. Cardiovascular interventions [JACC Cardiovasc Interv] 2019 Aug 12; Vol. 12 (15), pp. 1451-1461.
DOI:	10.1016/j.jcin.2019.04.019
Abstrakt:	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. (Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.)
Databáze:	MEDLINE
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