Early Multinational Experience of Transcatheter Tricuspid Valve Replacement for Treating Severe Tricuspid Regurgitation
Autor: | Geraldine Ong, Susheel Kodali, Andrea Colli, Krzysztof Bartus, Francesco Maisano, Patrick M. McCarthy, Josep Rodés-Cabau, Newell Robinson, Maurizio Taramasso, Alberto Forteza, George A. Petrossian, Neil Fam, Alberto Pozzoli, Markus Reinartz, Rodrigo Estévez-Loureiro, Mark J. Ricciardi, Samir R. Kapadia, Vinayak Bapat, Mark D. Peterson, Azeem Latib, François Dagenais, Vratika Agarwal, Jose L. Navia, Giuseppe Tarantini, Rebecca T. Hahn, Elisabeth Bédard, Horst Sievert |
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Rok vydání: | 2020 |
Předmět: |
Male
Cardiac Catheterization medicine.medical_specialty Time Factors medicine.medical_treatment Tricuspid valve replacement Regurgitation (circulation) tricuspid valve Severity of Illness Index Valve replacement medicine Humans In patient tricuspid regurgitation valve replacement Aged Aged 80 and over Heart Valve Prosthesis Implantation Tricuspid valve business.industry Recovery of Function Tricuspid Valve Insufficiency Surgical risk Surgery Treatment Outcome medicine.anatomical_structure Female Cardiology and Cardiovascular Medicine business |
Zdroj: | JACC: Cardiovascular Interventions. 13:2482-2493 |
ISSN: | 1936-8798 |
Popis: | The aim of this registry was to evaluate the feasibility and safety of transcatheter tricuspid valve implantation (TTVI) in patients with extreme surgical risk.Isolated tricuspid regurgitation (TR) surgery is associated with high in-hospital mortality.Thirty consecutive patients (mean age 75 ± 10 years; 56% women) from 10 institutions, with symptomatic functional TR, had institutional and notified body approval for compassionate use of the GATE TTVI system. Baseline, discharge, and 30-day follow-up echocardiographic data and procedural, in-hospital, and follow-up clinical outcomes were collected.At baseline, all patients had multiple comorbidities, severe or greater TR, and reduced baseline right ventricular function. Technical success was achieved in 26 of 30 patients (87%). Device malpositioning occurred in 4 patients, with conversion to open heart surgery in 2 (5%). Of those who received the device, 100% had reductions in TR of ≥1, and 75% experienced reductions of ≥2 grades, resulting in 18 of 24 of patients (76%) with mild or less TR at discharge. All patients had mild or less central TR. There was continued improvement in TR grade between discharge and 30 days in 15 of 19 patients (79%). In-hospital mortality was 10%. At mean follow-up of 127 ± 82 days, 4 patients (13%) had died. Of patients alive at follow-up, 62% were in New York Heart Association functional class I or II, with no late device-related adverse events.Compassionate treatment of severe, symptomatic functional TR using a first-generation TTVI device is associated with significant reduction in TR and improvement in functional status with acceptable in-hospital mortality. Further studies are needed to determine the appropriate patient population and long-term outcomes with TTVI therapy. |
Databáze: | OpenAIRE |
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