Transcatheter Edge-to-Edge Repair in Patients With Primary Tricuspid Regurgitation.
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История · было → стало
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Sugiura Atsushi, Dreyfus Julien, Bombace Sara, Ivannikova Maria, Bartkowiak Joanna, Haussig Stephan, Schneider Leonhard Moritz, Kassar Mohammad, Horn Patrick, Taramasso Maurizio, Iliadis Christos, Osawa Itsuki, Goto Tadahiro, Weber Marcel, Tanaka Tetsu, Zimmer Sebastian, Obadia Jean-François, Habib Gilbert, Bazire Baptiste, Iung Bernard, Bohbot Yohan, Tribouilloy Christophe, Donal Erwan, Nejjari Mohammed, Riant Elisabeth, Le Tourneau Thierry, Lavie-Badie Yoan, Coisne Augustin, Modine Thomas, Lim Pascal, Doguet Fabien, Selton-Suty Christine, Baldus Stephan, Kelm Malte, Praz Fabien, Rottbauer Wolfgang, Hans-Peter Linke Axel, Hahn Rebecca, Volker Rudolph, Messika-Zeitoun David, Lurz Philip, Nickenig Georg
Аннотация
OBJECTIVES: The aim of this study was to assess the safety and feasibility of TEER in patients with primary TR.
METHODS: The primary TR registry is a multicenter cohort study of patients with primary TR undergoing TEER. Echocardiographic assessment classified leaflet pathology into type 1 (flail), type 2 (billowing prolapse), type 3 (perforation), and type 4 (restricted mobility). The primary endpoint was TR reduction to moderate or less at discharge.
RESULTS: From December 2016 to April 2023, 114 patients (mean age 79.9 years, 53.5% men) were included. Most patients were in NYHA functional class III or IV (83.3%), with a median TRI-SCORE of 5.0. The TR pathologies were type 1 (28.1%), type 2 (61.4%), and type 4 (10.5%), with no type 3 cases. Device deployment was achieved in 95.6%, and 83.3% showed TR reduction to moderate or less. In-hospital mortality was 1.8%, and single-leaflet device attachment occurred in 3.5%. At 1 year, 79.7% of patients had TR moderate or less, with significant reductions in vena contracta (-5.0 mm; P < 0.001), annular diameter (-2.0 mm; P = 0.003), and mid right ventricular diameter (-3.0 mm; P < 0.001). NYHA functional class also improved significantly (NYHA functional class I or II: 17.1% at baseline vs 66.5% at follow-up; P < 0.001).
CONCLUSIONS: TEER is a safe and effective option for primary TR, promoting right heart reverse remodeling and symptomatic relief, offering a vital alternative to surgery in selected patients.