6-Month Outcomes of Tricuspid Valve Reconstruction for Patients With Severe Tricuspid Regurgitation

Nickenig, Georg; Weber, Marcel; Schueler, Robert; Hausleiter, Jörg; Näbauer, Michael; Bardeleben, Ralph Stephan von; Sotiriou, Efthymios; Schäfer, Ulrich; Deuschl, Florian; Kuck, Karl Heinz; Kreidel, Felix; Juliard, Jean Michel; Brochet, Éric; Latib, Azeem; Agricola, Eustachio; Baldus, Stephan; Friedrichs, Kai; Vandrangi, Prashanthi; Verta, Patrick; Hahn, Rebecca T.; Maisano, Francesco

doi:10.1016/j.jacc.2019.01.062

Cited by 194 publications

(105 citation statements)

References 26 publications

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“…Since many patients present at a very advanced stage of the disease, current thresholds for severity grading may not sufficiently reflect the variability of the clinical presentation. For this reason, a new grading scheme including the two additional grades "massive" and "torrential" with corresponding cut-offs has recently been proposed (64,65) and used in clinical studies (66,67). Preliminary data show an incremental prognostic value of the new classification beyond "severe" (68,69).…”

Section: Need For a New Grading Schemementioning

confidence: 99%

Imaging and Patient Selection for Transcatheter Tricuspid Valve Interventions

Winkel

Brugger

Khalique

et al. 2020

Front. Cardiovasc. Med.

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With the emergence of transcatheter solutions for the treatment of tricuspid regurgitation (TR) increased attention has been directed to the once neglected tricuspid valve (TV) complex. Recent studies have highlighted new aspects of valve anatomy and TR etiology. The assessment of valve morphology along with quantification of regurgitation severity and RV function pose several challenges to cardiac imagers guiding transcatheter valve procedures. This review article aims to give an overview over the role of modern imaging modalities during assessment and treatment of the TV.

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Section: Need For a New Grading Schemementioning

confidence: 99%

Imaging and Patient Selection for Transcatheter Tricuspid Valve Interventions

Winkel

Brugger

Khalique

et al. 2020

Front. Cardiovasc. Med.

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“…- Annuloplasty devices: There is a wide spectrum of annuloplasty devices under pre-clinical and clinical development, that could be categorized as ring-based direct annuloplasty systems (Cardioband [Edwards Lifescience, Irvine, California], Millipede IRIS [Boston Scientific, Marlborough, Massachusetts], DaVingi [Cardiac Implants, Tarrytown, New York]), ring-based indirect annuloplasty systems (transatrial intrapericardial tricuspid annuloplasty [Health and Cook Medical, Bloomington, Indiana]), or direct suture systems (Trialign [Mitralign, Tewksbury, Massachusetts], Tricinch [4Tech Cardio, Galway, Ireland], minimally invasive annuloplasty technology [Micro Interventional Devices, Newtown, Pennsylvania], pledget-assisted suture tricuspid annuloplasty). The Cardioband device was evaluated in the TrIcuspid Regurgitation RePAIr With CaRdioband Transcatheter System (TRIREPAIR) trial and, after the positive results obtained in terms of both procedural success and 6 months follow-up, it received the conformité européenne (CE) mark in the 2019 ( 15 ). Although the device was successfully implanted in all patients, 28% of the patients had at least severe or torrential TR (mean vena contracta of 9 mm) at follow-up, despite an overall reduction in the septo-lateral dimensions of 3.8 mm.…”

Section: Which Device For Which Patient? Moving Toward a Tailored Appmentioning

confidence: 99%

“…Due to its widespread use, numerous retrospective registries have identified the best anatomical scenario where TriClip can assure good echocardiographic results. The Transcatheter Clip Repair System in Patients With Moderate or Greater TR (TRILUMINATE) trial demonstrated the feasibility of the TriClip in a selected cohort of patients with stable results at 6 months follow-up ( 15 ). The PASCAL (Edwards Lifescience, Irvine, CA) clip is an alternative device, which has been used in the tricuspid position with good feasibility, safety and procedural outcomes ( 22 ).…”

Section: Which Device For Which Patient? Moving Toward a Tailored Appmentioning

confidence: 99%

Future Perspectives in Percutaneous Treatment of Tricuspid Regurgitation

Mangieri

Pagnesi

Regazzoli

et al. 2020

Front. Cardiovasc. Med.

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Tricuspid regurgitation (TR) has a not negligible prevalence and its severity is correlated with poorer outcomes. However, surgical options are rarely offered to these patients because of their high surgical risk. Given that medical therapy plays a limited role in the management of these patients, there is an increasing clinical need for transcatheter treatment options. Although, transcatheter tricuspid valve interventions (TTVIs) are still at an early stage, emerging data suggests their clinical effectiveness and safety, with preliminary results highlighting the potential benefits of transcatheter treatments over medical therapy. In this review, we highlight the challenges and future directions of current and emerging technologies dedicated to the treatment of TR along with an analysis of the next steps required in future clinical trials and studies dedicated to the treatment of the forgotten valve.

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“…In the TRI-REPAIR study, Cardioband implantation provided favourable clinical and functional outcomes at 6 months. 96 Nevertheless, how to define an optimal repair is still an unsolved issue. In the recent published mid-term outcomes of TriValve registry including 312 patients with severe TR, 82 procedural success (defined as patient alive at the end of the procedure, with the device successfully implanted and delivery system retrieved, with a residual TR grade < _2 by the investigators) was achieved in 72.8% of patients and was independently associated with increased mortality.…”

Section: Mitral Valvementioning

confidence: 99%

Uncertainties and challenges in surgical and transcatheter tricuspid valve therapy: a state-of-the-art expert review

Chang

Veen

Hahn

et al. 2019

European Heart Journal

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Tricuspid regurgitation (TR) is a frequent and complex problem, commonly combined with left-sided heart disease, such as mitral regurgitation. Significant TR is associated with increased mortality if left untreated or recurrent after therapy. Tricuspid regurgitation was historically often disregarded and remained undertreated. Surgery is currently the only Class I Guideline recommended therapy for TR, in the form of annuloplasty, leaflet repair, or valve replacement. As growing experience of transcatheter therapy in structural heart disease, many dedicated transcatheter tricuspid repair or replacement devices, which mimic well-established surgical techniques, are currently under development. Nevertheless, many aspects of TR are little understood, including the disease process, surgical or interventional risk stratification, and predictors of successful therapy. The optimal treatment timing and the choice of proper surgical or interventional technique for significant TR remain to be elucidated. In this context, we aim to highlight the current evidence, underline major controversial issues in this field and present a future roadmap for TR therapy.

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6-Month Outcomes of Tricuspid Valve Reconstruction for Patients With Severe Tricuspid Regurgitation

Cited by 194 publications

References 26 publications

Imaging and Patient Selection for Transcatheter Tricuspid Valve Interventions

Imaging and Patient Selection for Transcatheter Tricuspid Valve Interventions

Future Perspectives in Percutaneous Treatment of Tricuspid Regurgitation

Uncertainties and challenges in surgical and transcatheter tricuspid valve therapy: a state-of-the-art expert review

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