Concomitant Transcatheter Edge-to-Edge Treatment of Secondary Tricuspid and Mitral Regurgitation

Sisinni, Antonio; Taramasso, Maurizio; Praz, Fabien; Metra, Marco; Agricola, Eustachio; Margonato, Alberto; Fam, Neil; Estévez‐Loureiro, Rodrigo; Latib, Azeem; Messika–Zeitoun, David; Conradi, Lenard; Bardeleben, Ralph Stephan von; Sorajja, Paul; Hahn, Rebecca T.; Caravita, Sergio; Adamo, Marianna; Godino, Cosmo

doi:10.1016/j.jcin.2022.11.022

Cited by 12 publications

(3 citation statements)

References 84 publications

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“…In these cases, patients with severe or greater TR and suitable anatomy for TV TEER, especially those exhibiting an atrial-predominant phenotype and preserved RV-PA coupling, without pulmonary hypertension or with isolated post-capillary pulmonary hypertension, may significantly benefit from a combined transcatheter approach addressing both TR and mitral regurgitation. 54 …”

Section: Introductionmentioning

confidence: 99%

Transthoracic and transoesophageal echocardiography for tricuspid transcatheter edge-to-edge repair: a step-by-step protocol

Mazzola,

Giannini,

Sticchi

et al. 2024

European Heart Journal - Imaging Methods and Practice

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Tricuspid regurgitation (TR) carries an unfavourable prognosis and often leads to progressive right ventricular (RV) failure. Secondary TR accounts for over 90% of cases and is caused by RV and/or tricuspid annulus dilation, in the setting of left heart disease or pulmonary hypertension. Surgical treatment for isolated TR entails a high operative risk and is seldom performed. Recently, transcatheter edge-to-edge repair (TEER) has emerged as a low-risk alternative treatment in selected patients. Although the experience gained from mitral TEER has paved the way for the technique’s adaptation to the tricuspid valve (TV), its anatomical complexity necessitates precise imaging. To this end, a comprehensive protocol integrating 2D and 3D imaging from both transthoracic echocardiography (TTE) and transoesophageal echocardiography (TOE) plays a crucial role. TTE allows for an initial morphological assessment of the TV, quantification of TR severity, evaluation of biventricular function, and non-invasive haemodynamic evaluation of pulmonary circulation. TOE, conversely, provides a detailed evaluation of TV morphology, enabling precise assessment of TR mechanism and severity, and represents the primary method for determining eligibility for TEER. Once a patient is considered eligible for TEER, TOE, alongside fluoroscopy, will guide the procedure in the catheterization lab. High-quality TOE imaging is crucial for patient selection and to achieve procedural success. The present review examines the roles of TTE and TOE in managing patients with severe TR eligible for TEER, proposing the step-by-step protocol successfully adopted in our centre.

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Section: Introductionmentioning

confidence: 99%

Transthoracic and transoesophageal echocardiography for tricuspid transcatheter edge-to-edge repair: a step-by-step protocol

Mazzola,

Giannini,

Sticchi

et al. 2024

European Heart Journal - Imaging Methods and Practice

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“…[108][109][110] On the other hand, in patients with multiple VHD and high or prohibitive surgical risk undergoing transcatheter interventions, the role of concomitant treatment of left-sided lesions and TV is still unclear. 111,112 As mentioned above, persistence of severe TR after transcatheter left-sided VHD correction is associated with a poorer outcome. 99 Also, RVD was found to be a strong predictor of poor prognosis in patients undergoing transcatheter left-sided VHD intervention 113,114 as well as in those receiving TTVI.…”

Section: Tricuspid Valve Interventionsmentioning

confidence: 94%

“…The benefit of TR correction during left‐sided VHD surgery has been demonstrated 108–110 . On the other hand, in patients with multiple VHD and high or prohibitive surgical risk undergoing transcatheter interventions, the role of concomitant treatment of left‐sided lesions and TV is still unclear 111,112 . As mentioned above, persistence of severe TR after transcatheter left‐sided VHD correction is associated with a poorer outcome 99 .…”

Section: Managementmentioning

confidence: 99%

Epidemiology, pathophysiology, diagnosis and management of chronic right‐sided heart failure and tricuspid regurgitation. A clinical consensus statement of the Heart Failure Association (HFA) and the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC

Adamo,

Chioncel,

Pagnesi

et al. 2024

European J of Heart Fail

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Right‐sided heart failure and tricuspid regurgitation are common and strongly associated with poor quality of life and an increased risk of heart failure hospitalizations and death. While medical therapy for right‐sided heart failure is limited, treatment options for tricuspid regurgitation include surgery and, based on recent developments, several transcatheter interventions. However, the patients who might benefit from tricuspid valve interventions are yet unknown, as is the ideal time for these treatments given the paucity of clinical evidence. In this context, it is crucial to elucidate etiology and pathophysiological mechanisms leading to right‐sided heart failure and tricuspid regurgitation in order to recognize when tricuspid regurgitation is a mere bystander and when it can cause or contribute to heart failure progression. Notably, early identification of right heart failure and tricuspid regurgitation may be crucial and optimal management requires knowledge about the different mechanisms and causes, clinical course and presentation, as well as possible treatment options.The aim of this clinical consensus statement is to summarize current knowledge about epidemiology, pathophysiology and treatment of tricuspid regurgitation in right‐sided heart failure providing practical suggestions for patient identification and management.This article is protected by copyright. All rights reserved.

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Contemporary Approach to Tricuspid Regurgitation: Knowns, Unknowns, and Future Challenges

Samim,

Dernektsi,

Brugger

et al. 2024

Canadian Journal of Cardiology

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Concomitant Transcatheter Edge-to-Edge Treatment of Secondary Tricuspid and Mitral Regurgitation

Cited by 12 publications

References 84 publications

Transthoracic and transoesophageal echocardiography for tricuspid transcatheter edge-to-edge repair: a step-by-step protocol

Transthoracic and transoesophageal echocardiography for tricuspid transcatheter edge-to-edge repair: a step-by-step protocol

Epidemiology, pathophysiology, diagnosis and management of chronic right‐sided heart failure and tricuspid regurgitation. A clinical consensus statement of the Heart Failure Association (HFA) and the European Association of Percutaneous Cardiovascular Interventions (EAPCI) of the ESC

Contemporary Approach to Tricuspid Regurgitation: Knowns, Unknowns, and Future Challenges

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