1-Year Outcomes After Edge-to-Edge Valve Repair for Symptomatic Tricuspid Regurgitation: Results From the TriValve Registry.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Mehr Michael, Taramasso Maurizio, Besler Christian, Ruf Tobias, Connelly Kim A, Weber Marcel, Yzeiraj Ermela, Schiavi Davide, Mangieri Antonio, Vaskelyte Laura, Alessandrini Hannes, Deuschl Florian, Brugger Nicolas, Ahmad Hasan, Biasco Luigi, Orban Mathias, Deseive Simon, Braun Daniel, Rommel Karl-Philipp, Pozzoli Alberto, Frerker Christian, Näbauer Michael, Massberg Steffen, Pedrazzini Giovanni, Tang Gilbert H L, Windecker Stephan, Schäfer Ulrich, Kuck Karl-Heinz, Sievert Horst, Denti Paolo, Latib Azeem, Schofer Joachim, Nickenig Georg, Fam Neil, von Bardeleben Ralph Stephan, Lurz Philipp, Maisano Francesco, Hausleiter Jörg
Аннотация
BACKGROUND: Transcatheter edge-to-edge repair has been successfully performed in selected patients with symptomatic tricuspid regurgitation (TR) and high risk for surgery, but outcome data are sparse.
METHODS: This analysis of the multicenter international TriValve (Transcatheter Tricuspid Valve Therapies) registry included 249 patients with severe TR treated with edge-to-edge repair in compassionate and/or off-label use. Clinical and echocardiographic outcomes were prospectively collected and retrospectively analyzed.
RESULTS: In 249 patients (mean age 77 ± 9 years; European System for Cardiac Operative Risk Evaluation II score 6.4% [interquartile range: 3.9% to 13.9%]), a successful procedure with TR reduction to grade ≤2+ was achieved in 77% by placement of 2 ± 1 tricuspid clips. Concomitant treatment of severe TR and mitral regurgitation was performed in 52% of patients. At 1-year follow-up, significant and durable improvements in TR severity (TR ≤2+ in 72% of patients) and New York Heart Association functional class (≤II in 69% of patients) were observed. All-cause mortality was 20%, and the combined rate of mortality and unplanned hospitalization for heart failure was 35%. Predictors of procedural failure included effective regurgitant orifice area, tricuspid coaptation gap, tricuspid tenting area, and absence of central or anteroseptal TR jet location. Predictors of 1-year mortality were procedural failure, worsening kidney function, and absence of sinus rhythm.
CONCLUSIONS: Transcatheter tricuspid edge-to-edge repair can achieve TR reduction at 1 year, resulting in significant clinical improvement. Predictors of procedural failure and 1-year mortality identified here may help select patients who will benefit most from this therapy.