Short-Term Clinical Outcomes of Transcatheter Tricuspid Valve Repair With the Third-Generation MitraClip XTR System
| Autor: | Andres Beiras-Fernandez, Martin Geyer, Michaela Hell, Patrick Gerdes, Thomas Münzel, Felix Kreidel, Markus Vosseler, Alexander Tamm, T Ruf, Ralph Stephan von Bardeleben, Jaqueline Grace da Roche e Silva, Rebecca T. Hahn |
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| Rok vydání: | 2021 |
| Předmět: |
Heart Valve Prosthesis Implantation
Cardiac Catheterization medicine.medical_specialty Tricuspid valve business.industry MitraClip Mitral Valve Insufficiency Regurgitation (circulation) 030204 cardiovascular system & hematology Tricuspid Valve Insufficiency Third generation 03 medical and health sciences Treatment Outcome 0302 clinical medicine medicine.anatomical_structure Internal medicine medicine Cardiology Humans XTR Tricuspid Valve 030212 general & internal medicine TRICUSPID VALVE REPAIR Cardiology and Cardiovascular Medicine business |
| Zdroj: | JACC: Cardiovascular Interventions. 14:1231-1240 |
| ISSN: | 1936-8798 |
| DOI: | 10.1016/j.jcin.2021.03.033 |
| Popis: | The aim of this study was to assess 30-day outcomes of transcatheter edge-to-edge repair with the MitraClip XTR for significant tricuspid regurgitation (TR), relative to baseline coaptation gap sizes (CGS).Transcatheter edge-to-edge repair using the MitraClip NT for patients with significant TR is safe and efficacious; the utility of the MitraClip XTR is unknown.Patients with significant, symptomatic TR treated at a single site between April 2018 and December 2019, with consent and with complete data, were included (n = 50). Baseline and 30-day echocardiograms were assessed by an echocardiography core laboratory. Patients were divided into 3 subgroups on the basis of site-assessed CGS: subgroup I (7 mm), subgroup II (7 to 10 mm), and subgroup III (10 mm).Technical success of the MitraClip XTR implantation was 100% (88% in the septal-anterior position) using a median of 2 clips (interquartile range: 1 to 2). At 30 days, single-leaflet detachment was noted in 3 patients (6%), with no instances of device embolization. TR was reduced by 1 grade in subgroup I and by 2 grades in subgroups II and III. New York Heart Association functional class was reduced by 1 class in all 3 subgroups. The 6-min walk distance increased in subgroup I (+115 m; p = 0.014) and subgroup II (+31.5 m; p = 0.028) but not subgroup III (+50 m; p = 0.999). A CGS of ≤8.4 mm was predictive of a reduction to moderate or less TR.MitraClip XTR implantation is a safe, effective treatment for a wider range of CGS in patients with symptomatic, significant TR than prior device iterations. All patients showed improvement in New York Heart Association functional class, and those with CGS 10 mm also experienced improved functional capacity. |
| Databáze: | OpenAIRE |
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