Transcatheter tricuspid valve replacement in patients with severe tricuspid regurgitation
| Autor: | Fanglin Lu, Yifan Bai, Bailing Li, Guang-Wei Zhou, Xiaohong Liu, Lin Han, Xiangbin Pan, Cheng-Liang Cai, Zhao An, Zhiyun Xu, Anson Cheung, Ye Ma, Fan Qiao, Xu Meng, Jun Wang, Jian Yang, Zhigang Song, Jiafeng Wang, Haibo Zhang, Nian-Guo Dong, Shengshou Hu |
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| Rok vydání: | 2021 |
| Předmět: |
Male
Cardiac Catheterization medicine.medical_specialty Time Factors medicine.medical_treatment Perforation (oil well) Severity of Illness Index law.invention Risk Factors law medicine Humans Thoracotomy Aged Heart Valve Prosthesis Implantation Tricuspid valve Vena contracta business.industry valvular heart disease Recovery of Function Middle Aged medicine.disease Intensive care unit Tricuspid Valve Insufficiency Surgery Treatment Outcome medicine.anatomical_structure Ventricle Feasibility Studies Female Tricuspid Valve Cardiology and Cardiovascular Medicine business Complication Echocardiography Transesophageal |
| Zdroj: | Heart. 107:1664-1670 |
| ISSN: | 1468-201X 1355-6037 |
| DOI: | 10.1136/heartjnl-2020-318199 |
| Popis: | ObjectiveTricuspid regurgitation (TR) is a common valvular heart disease with unsatisfactory medical therapeutics and high surgical mortality. The present study aims to evaluate the safety and effectiveness of transcatheter tricuspid valve replacement (TTVR) in high-risk patients with severe TR.MethodsThis was a compassionate multicentre study. Between September 2018 and November 2019, 46 patients with TR who were not suitable for surgery received compassionate TTVR under general anaesthesia and the guidance of trans-oesophageal echocardiography and fluoroscopy in four institutions. Access to the tricuspid valve was obtained via a minimally invasive thoracotomy and transatrial approach. Patients’ data at baseline, before discharge, 30 days and 6 months after the procedure were collected.ResultsAll patients had severe TR with vena contracta width of 12.6 (11.0, 14.5) mm. Procedural success (97.8%) was achieved in all but one case with right ventricle perforation. The procedural time was 150.0 (118.8, 180.0) min. Intensive care unit time was 2.0 (1.0, 4.0) days. 6-month mortality was 17.4%. Device migration occurred in one patient (2.4%) during follow-up. Transthoracic echocardiography at 6 months after operation showed TR was significantly reduced (none/trivial in 33, mild in 4 and moderate in 1) and the primary safety end point was achieved in 38 cases (82.6%). Patients suffered from peripheral oedema and ascites decreased from 100.0% and 47.8% at baseline to 2.6% and 0.0% at 6 months.ConclusionsThe present study showed TTVR was feasible, safe and with low complication rates in patients with severe TR. |
| Databáze: | OpenAIRE |
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