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Transcatheter tricuspid valve replacement in patients with severe tricuspid regurgitation.

Authors :
Fang-Lin Lu
Zhao An
Ye Ma
Zhi-Gang Song
Cheng-Liang Cai
Bai-Ling Li
Guang-Wei Zhou
Lin Han
Jun Wang
Yi-Fan Bai
Xiao-Hong Liu
Jia-Feng Wang
Xu Meng
Hai-Bo Zhang
Jian Yang
Nian-Guo Dong
Sheng-Shou Hu
Xiang-Bin Pan
Cheung, Anson
Fan Qiao
Source :
Heart; Oct2021, Vol. 107 Issue 20, p1664-1670, 7p
Publication Year :
2021

Abstract

<bold>Objective: </bold>Tricuspid 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.<bold>Methods: </bold>This 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.<bold>Results: </bold>All 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.<bold>Conclusions: </bold>The present study showed TTVR was feasible, safe and with low complication rates in patients with severe TR. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
13556037
Volume :
107
Issue :
20
Database :
Complementary Index
Journal :
Heart
Publication Type :
Academic Journal
Accession number :
152639707
Full Text :
https://doi.org/10.1136/heartjnl-2020-318199