Impact of Massive or Torrential Tricuspid Regurgitation in Patients Undergoing Transcatheter Tricuspid Valve Intervention
| Autor: | Daniel Braun, Ulrich Schäfer, Horst Sievert, Francesco Maisano, Martin B. Leon, Christian Frerker, Abdullah Alkhodair, Hannes Alessandrini, Rodrigo Estévez-Loureiro, Florian Deuschl, François Philippon, Guillem Muntané-Carol, Alberto Pozzoli, Joachim Schofer, Sabine de Bruijn, Adrian Attinger-Toller, Kim A. Connelly, Mizuki Miura, Michel Zuber, Tamin Nazif, Karl-Heinz Kuck, Paolo Denti, Luigi Biasco, TriValve Investigators, Dominique Himbert, Edwin C. Ho, Georg Nickenig, Stephan Windecker, Karl-Philipp Rommel, Fabien Praz, Maurizio Taramasso, Michael Mehr, Holger Thiele, Neil Fam, Mirjam Winkel, Rishi Puri, Gilbert H.L. Tang, Giovanni Pedrazzini, Christian Besler, Jörg Hausleiter, Ryan Kaple, Vanessa Moñivas, Rebecca T. Hahn, Felix Kreidel, Mara Gavazzoni, Marcel Weber, John G. Webb, Josep Rodés-Cabau, Eric Brochet, Azeem Latib, Alexander Lauten, Susheel Kodali, J.-M. Juliard, Ralph Stephan von Bardeleben, Alec Vahanian, Philipp Lurz |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Cardiac Catheterization Time Factors 030204 cardiovascular system & hematology Patient Readmission Risk Assessment Severity of Illness Index 03 medical and health sciences 0302 clinical medicine Risk Factors Internal medicine medicine Clinical endpoint Humans 030212 general & internal medicine Registries 610 Medicine & health Survival rate Aged Retrospective Studies Aged 80 and over Heart Valve Prosthesis Implantation Vena contracta Tricuspid valve business.industry Incidence (epidemiology) Hazard ratio Recovery of Function medicine.disease Confidence interval Tricuspid Valve Insufficiency Europe medicine.anatomical_structure Treatment Outcome Heart failure North America Cardiology Disease Progression Female Tricuspid Valve Cardiology and Cardiovascular Medicine business |
| Zdroj: | JACC. Cardiovascular interventions. 13(17) |
| ISSN: | 1876-7605 |
| Popis: | Objectives The aim of this study was to assess the clinical outcome of baseline massive or torrential tricuspid regurgitation (TR) after transcatheter tricuspid valve intervention (TTVI). Background The use of TTVI to treat symptomatic severe TR has been increasing rapidly, but little is known regarding the impact of massive or torrential TR beyond severe TR. Methods The study population comprised 333 patients with significant symptomatic TR from the TriValve Registry who underwent TTVI. Mid-term outcomes after TTVI were assessed according to the presence of massive or torrential TR, defined as vena contracta width ≥14 mm. Procedural success was defined as patient survival after successful device implantation and delivery system retrieval, with residual TR ≤2+. The primary endpoint comprised survival rate and freedom from rehospitalization for heart failure, survival rate, and rehospitalization at 1 year. Results Baseline massive or torrential TR and severe TR were observed in 154 patients (46.2%) and 179 patients (53.8%), respectively. Patients with massive or torrential TR had a higher prevalence of ascites than those with severe TR (27.3% vs. 20.4%, respectively; p = 0.15) and demonstrated a similar procedural success rate (83.2% vs. 77.3%, respectively; p = 0.21). The incidence of peri-procedural adverse events was low, with no significant between-group differences. Freedom from the composite endpoint was significantly lower in patients with massive or torrential TR than in those with severe TR, which was significantly associated with an increased risk for 1-year death of any cause or rehospitalization for heart failure (adjusted hazard ratio: 1.91; 95% confidence interval: 1.10 to 3.34; p = 0.022). Freedom from the composite endpoint was significantly higher in patients with massive or torrential TR when procedural success was achieved (69.9% vs. 54.2%, p = 0.048). Conclusions Baseline massive or torrential TR is associated with an increased risk for all-cause mortality and rehospitalization for heart failure 1 year after TTVI. Procedural success is related to better outcomes, even in the presence of baseline massive or torrential TR. (International Multisite Transcatheter Tricuspid Valve Therapies Registry [TriValve]; NCT03416166) |
| Databáze: | OpenAIRE |
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