Management and Outcome of Failed Transcatheter Tricuspid Edge-to-Edge Repair: Insights From the FATE International Registry.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
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De Marco Federico, Calamita Gianmaria, Ardizzone Valentina, Winkel Mirjam Gauri, Kassar Mohammad, Praz Fabien, Van Mieghem Nicolas M, Ooms Joris F W, Gerçek Muhammed, Rudolph Felix, Adamo Marianna, Coisne Augustin, Arlanda Jérémie, Lurz Philipp, Estévez-Loureiro Rodrigo, Fam Neil P, Schofer Joachim, Brinkmann Christina, Urena Marina, Ducrocq Gregory, Sinning Jan-Malte, Geisler Tobias, Azzano Alessia, Brscic Elvis, Millin Antonella, Latib Azeem, Taramasso Maurizio, Rubbio Antonio Popolo, Bedogni Francesco, Brunner Stephanie, Toggweiler Stefan, Swaans Martin J, Timmers Leo, Giannini Francesco, Ielasi Alfonso, Oliva Omar, Dumonteil Nicolas, Tchetchè Didier, Arzamendi Dabit, Maisero Giulia, Tarantini Giuseppe, Crimi Gabriele, Porto Italo, Castriota Fausto, Ferri Luca, Montorfano Matteo, Sticchi Alessandro, Lopez-Laporte Maria, Messika-Zeitoun David, Labinaz Marino, Lüdike Peter, Sievert Horst, Antonelli Giulia, Fazzari Fabio, Ferrari Cristina, Mangieri Antonio
Аннотация
OBJECTIVES: The aim of this study was to investigate the incidence, management, and outcomes of T-TEER device-related failures due to loss of leaflet insertion, single-leaflet device attachment, or device embolization, offering insights into these adverse events.
METHODS: The retrospective, multicenter FATE (Failed Tricuspid Transcatheter Edge-to-Edge) registry identified all device-related failures associated with moderate or greater residual or recurrent TR among 2,278 consecutive T-TEER procedures performed at 31 centers from 2017 to 2024. Failure mechanisms were classified by multiparametric echocardiography. Coprimary endpoints were the incidence and management of device-related failure and the composite of death or heart failure rehospitalization.
RESULTS: Among 2,278 T-TEER procedures, 123 device-related failures (5.4%) were identified (loss of leaflet insertion, 24%; single-leaflet device attachment, 75%; embolization, 1%), mostly diagnosed early and associated with severe or greater TR in 73%. Management was medical therapy in 54% and reintervention in 46%. Reintervention achieved greater TR reduction and right atrial reverse remodeling than medical therapy, but over a median follow-up period of 255 days, the composite of death or heart failure rehospitalization remained frequent (38.2%) and did not differ between strategies. Higher TRI-SCORE, acute kidney injury, and greater discharge TR severity independently predicted adverse outcomes.
CONCLUSIONS: Device-related failure after T-TEER is uncommon but clinically relevant. Reintervention achieves greater TR reduction and right atrial reverse remodeling than medical therapy, but events remain similar between both strategies.