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Transcatheter Pulmonary Valve Replacement Reduces Tricuspid Regurgitation in Patients With Right Ventricular Volume/Pressure Overload.
- Source :
-
Journal of the American College of Cardiology (JACC) . Oct2016, Vol. 68 Issue 14, p1525-1535. 11p. - Publication Year :
- 2016
-
Abstract
- <bold>Background: </bold>Tricuspid regurgitation (TR) is a common and important comorbidity in patients with postoperative right ventricular outflow tract (RVOT) obstruction or pulmonary regurgitation (PR). Transcatheter pulmonary valve replacement (TPVR) has become a useful tool in the management of postoperative RVOT obstruction and PR, but it is unknown whether relief of the right ventricular volume and/or pressure overload by TPVR will have a beneficial effect on TR, as is often seen with surgical pulmonary valve replacement.<bold>Objectives: </bold>This study sought to assess the prevalence of and factors associated with significant TR in patients undergoing TPVR for RVOT obstruction or PR.<bold>Methods: </bold>Data were combined from 3 prospective multicenter trials of patients referred for TPVR. Follow-up data through 5 years post-implantation were analyzed.<bold>Results: </bold>Of 300 patients studied, 77 (25.6%) had moderate or severe TR at baseline. After TPVR, TR severity was improved in 65% of those patients, and more than one-half had mild TR or less TR at discharge. Of 13 patients with severe TR pre-implantation, only 1 had severe TR at 1-year follow-up and beyond. Moderate or severe baseline TR was associated with shorter freedom from RVOT reintervention after TPVR.<bold>Conclusions: </bold>In this prospective multicenter study of post-operative patients with RVOT obstruction and/or PR, TR was common. In patients with significant baseline TR, TPVR resulted in clinically relevant acute reductions in TR that persisted over at least 5 years of follow-up. These observations support the application of TPVR therapy in patients with RVOT obstruction or PR who are anatomically suitable, even in the setting of significant concomitant TR. [ABSTRACT FROM AUTHOR]
- Subjects :
- *VENTRICULAR outflow obstruction
*TRICUSPID valve diseases
*HEART valve transplantation
*COMORBIDITY
*PULMONARY valve
*LONGITUDINAL method
*PATIENTS
*SURGERY
*THERAPEUTICS
*COMPARATIVE studies
*PROSTHETIC heart valves
*HEART valve diseases
*RESEARCH methodology
*MEDICAL cooperation
*RESEARCH
*EVALUATION research
*SEVERITY of illness index
*DISEASE complications
Subjects
Details
- Language :
- English
- ISSN :
- 07351097
- Volume :
- 68
- Issue :
- 14
- Database :
- Academic Search Index
- Journal :
- Journal of the American College of Cardiology (JACC)
- Publication Type :
- Academic Journal
- Accession number :
- 118178238
- Full Text :
- https://doi.org/10.1016/j.jacc.2016.07.734