Real-World Outcomes of Transcatheter Tricuspid Valve Replacement: Analysis From the STS/ACC TVT 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.
Makkar Raj R, Gupta Aakriti, O'Neill Brian P, Lalani Christina, Sharma Rahul P, Yadav Pradeep, Frisoli Tiberio M, Thourani Vinod, Makar Moody, Eleid Mackram F, Lee James, Babaliaros Vasilis C, Haeffele Christiane, Bajwa Tanvir K, Flueckiger Peter, Cubeddu Robert J, Davidson Laura J, Padang Ratnasari, Spinetto Pedro Villablanca, Allaqaband Suhail, Narang Akhil, Williams Mathew, Gleason Patrick, Tang Gilbert H L, Khera Sahil, Vavalle John P, Byku Isida, Depta Jeremiah P, Garcia Santiago, Kapadia Samir, Zajarias Alan, Chanin Jake M, Kodali Susheel K, Herrmann Howard C, Morse M Andrew, Petrossian George, Sivak Joseph A, Hahn Rebecca T, Song Yang, Leon Martin B, Yeh Robert W, Davidson Charles J
Аннотация
OBJECTIVE: To evaluate 30-day clinical, echocardiographic, and health status outcomes of TTVR in real-world use.
DESIGN, SETTING, AND POPULATION: Retrospective cohort study of all consecutive patients who underwent TTVR in the US from February 2024 through March 2025 in the Society of Thoracic Surgeons/American College of Cardiology Transcatheter Valve Therapy Registry. Patients had symptomatic, severe TR despite optimal medical therapy and TTVR was deemed appropriate by a heart team. Statistical analysis was conducted from September 2025 to February 2026.
EXPOSURE: Device-enabled TTVR.
MAIN OUTCOMES AND MEASURES: Thirty-day event rates (all-cause death, stroke, bleeding, new cardiac implantable electronic device [CIED] implantation, heart failure hospitalizations), TR reduction, and changes in health status (New York Heart Association [NYHA] functional class and Kansas City Cardiomyopathy Questionnaire Overall Summary [KCCQ-OS] score) are reported. Subgroup analyses examined the impact of baseline CIED status on outcomes.
RESULTS: Among 1034 attempted procedures at 82 centers (mean [SD] age, 77.1 [10.6] years; 69.1% female; 73.2% NYHA functional class III/IV), a valve was successfully implanted in 1017 patients (98.4%). Mild or less TR was achieved in 98.4% of patients post procedure and in 97.7% at 30 days. At 30 days, all-cause mortality was 3.1%; stroke, 0.2%; bleeding, 7.9%; new CIED, 15.9% in CIED-naive patients; and heart failure hospitalization, 3.1%. There were significant improvements in NYHA functional class (class I/II, 82.7%; P < .001) and mean KCCQ-OS score (22.4 points; P < .001) from baseline to 30 days. There were no significant differences in 30-day mortality (P = .47), heart failure hospitalization (P > .99), and functional outcomes (P = .55) when patients were stratified by baseline CIED status.
CONCLUSIONS AND RELEVANCE: Early US real-world experience with TTVR confirms safety and effectiveness in patients with severe TR. Thirty-day outcomes are consistent with the TRISCEND II pivotal trial, demonstrating acceptable safety, near-complete TR elimination, and significant health status improvements in an older, comorbid population. Rates of new CIED implantation and bleeding were lower than randomized clinical trial experience.