Transcatheter tricuspid valve replacement in patients with severe tricuspid regurgitation. Issue 20 (8th January 2021)

• Record Type: Journal Article
• Authors: Lu, Fang-Lin; An, Zhao; Ma, Ye; Song, Zhi-Gang; Cai, Cheng-Liang; Li, Bai-Ling; Zhou, Guang-Wei; Han, Lin; Wang, Jun; Bai, Yi-Fan; Liu, Xiao-Hong; Wang, Jia-Feng; Meng, Xu; Zhang, Hai-Bo; Yang, Jian; Dong, Nian-Guo; Hu, Sheng-Shou; Pan, Xiang-Bin; Cheung, Anson; Qiao, Fan; Xu, Zhi-Yun
• Is Part Of: Heart. Volume 107:Issue 20(2021)
• Page Start: 1664
• Page End: 1670
• Publication Date: 2021-01-08
• Subjects: valve disease surgery -- transcatheter valve interventions -- tricuspid valve disease; Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2020-318199
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Objective: 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. Methods: 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. Results: 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. Conclusions: The present study showed TTVR was feasible, safe and with low complication rates in patients with severe TR.