Transcatheter treatment for tricuspid valve disease

Praz, Fabien; Muraru, Denisa; Kreidel, Felix; Lurz, Philipp; Hahn, Rebecca T.; Delgado, Victoria; Senni, Michele; Bardeleben, Ralph Stephan von; Nickenig, Georg; Hausleiter, Jörg; Mangieri, Antonio; Zamorano, José Luís; Prendergast, Bernard; Maisano, Francesco

doi:10.4244/eij-d-21-00695

Cited by 208 publications

(197 citation statements)

References 119 publications

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“…137 For appropriately selected patients with HFrEF, refractory symptoms despite maximally titrated GDMT, and significant functional mitral (and potentially tricuspid) regurgitation, transcatheter edge-to-edge repair (TEER) should be considered in accordance with extant HF and valvular heart disease guidelines. 22,[138][139][140] Further, although the recent REDUCE LAP-HF II trial did not show the benefit of an interatrial shunt device among patients with symptomatic HF with LVEF ≥ 40%, prespecified subgroup analysis disclosed benefit among patients with a peak exercise pulmonary vascular resistance of <1.74 Wood units, potentially representing a responder group meriting dedicated prospective evaluation. 140 Finally, invasive remote monitoring techniques, such as implantable wireless pulmonary arterial pressure sensors (e.g., Cardio-MEMS), CIED-based hemodynamic monitors, and novel wearable biosensors can provide near-real-time diagnostic information enabling long-term avoidance of HF rehospitalization and associated morbidity.…”

Section: Omecamtiv Mecarbil May Have Uniquely Favorable Properties In...mentioning

confidence: 99%

“…His bundle pacing may be a future modality in this group 137 . For appropriately selected patients with HFrEF, refractory symptoms despite maximally titrated GDMT, and significant functional mitral (and potentially tricuspid) regurgitation, transcatheter edge‐to‐edge repair (TEER) should be considered in accordance with extant HF and valvular heart disease guidelines 22,138‐140 . Further, although the recent REDUCE LAP‐HF II trial did not show the benefit of an interatrial shunt device among patients with symptomatic HF with LVEF ≥ 40%, prespecified subgroup analysis disclosed benefit among patients with a peak exercise pulmonary vascular resistance of <1.74 Wood units, potentially representing a responder group meriting dedicated prospective evaluation 140 .…”

Section: Hospitalization For Worsening Hfmentioning

confidence: 99%

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Evolving therapeutic strategies for patients hospitalized with new or worsening heart failure across the spectrum of left ventricular ejection fraction

Ostrominski

Vaduganathan

2022

Clinical Cardiology

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Heart failure (HF) is a chronic, progressive, and increasingly prevalent syndrome characterized by stepwise declines in health status and residual lifespan. Despite significant advancements in both pharmacologic and nonpharmacologic management approaches for chronic HF, the burden of HF hospitalization—whether attributable to new‐onset (de novo) HF or worsening of established HF—remains high and contributes to excess HF‐related morbidity, mortality, and healthcare expenditures. Owing to a paucity of evidence to guide tailored interventions in this heterogeneous group, management of acute HF events remains largely subject to clinician discretion, relying principally on alleviation of clinical congestion, as‐needed correction of hemodynamic perturbations, and concomitant reversal of underlying trigger(s). Following acute stabilization, the subsequent phase of care primarily involves interventions known to improve long‐term outcomes and rehospitalization risk, including initiation and optimization of disease‐modifying pharmacotherapy, targeted use of adjunctive therapies, and attention to contributing comorbid conditions. However, even with current standards of care many patients experience recurrent HF hospitalization, or after admission incur worsening clinical trajectories. These patterns highlight a persistent unmet need for evidence‐based approaches to inform in‐hospital HF care and call for renewed focus on urgent implementation of interventions capable of ameliorating risk of worsening HF. In this review, we discuss key contemporary and emerging therapeutic strategies for patients hospitalized with de novo or worsening HF.

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Section: Omecamtiv Mecarbil May Have Uniquely Favorable Properties In...mentioning

confidence: 99%

Section: Hospitalization For Worsening Hfmentioning

confidence: 99%

Evolving therapeutic strategies for patients hospitalized with new or worsening heart failure across the spectrum of left ventricular ejection fraction

Ostrominski

Vaduganathan

2022

Clinical Cardiology

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“…As recently proposed, it can be classified as secondary (functional), atrial or ventricular, primary (organic) and related to a cardiac implantable electronic device. 61 It is frequently observed and, if left untreated, is associated with poor prognosis in patients with left-sided heart disease, 62 who are at an increased risk of death, independently of pulmonary pressures and right ventricular dysfunction. 63 In addition, in individuals with left-sided valvular surgery and transcatheter procedures, tricuspidal valve regurgitation negatively predicts prognosis and may not improve or even worsen due to further tricuspidal valve annulus dilatation and right ventricular dysfunction.…”

Section: Tricuspidal Valve Diseasementioning

confidence: 99%

Role of computed tomography in transcatheter replacement of ‘other valves’: a comprehensive review of preprocedural imaging

Pugliese

Ricci

Luciano

et al. 2022

Journal of Cardiovascular Medicine

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Transcatheter procedures for heart valve repair or replacement represent a valid alternative for treating patients who are inoperable or at a high risk for open-heart surgery. The transcatheter approach has become predominant over surgical intervention for aortic valve disease, but it is also increasingly utilized for diseases of the ‘other valves’, that is the mitral and, to a lesser extent, tricuspid and pulmonary valve. Preprocedural imaging is essential for planning the transcatheter intervention and computed tomography has become the main imaging modality by providing information that can guide the type of treatment and choice of device as well as predict outcome and prevent complications. In particular, preprocedural computed tomography is useful for providing anatomic details and simulating the effects of device implantation using 3D models. Transcatheter mitral valve replacement is indicated for the treatment of mitral regurgitation, either primary or secondary, and computed tomography is crucial for the success of the procedure. It allows evaluating the mitral valve apparatus, the surrounding structures and the left heart chambers, identifying the best access route and the landing zone and myocardial shelf, and predicting obstruction of the left ventricular outflow tract, which is the most frequent postprocedural complication. Tricuspid valve regurgitation with or without stenosis and pulmonary valve stenosis and regurgitation can also be treated using a transcatheter approach. Computer tomography provides information on the tricuspid and pulmonary valve apparatus, the structures that are spatially related to it and may be affected by the procedure, the right heart chambers and the right ventricular outflow tract.

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“…The realization of this ominous situation has led to a recent explosion of studies and articles related both to tricuspid valve structural interventions and to efforts to reappraise the etiology and classification of TR. 1 We are indeed aware that TR can be classified as primary, secondary (atrial vs ventricular), and cardiovascular implantable electronic device related. 1 We are also aware that a notable percentage of patients who have undergone left-sided heart surgery will develop significant TR in their life span.…”

mentioning

confidence: 99%

“… 1 We are indeed aware that TR can be classified as primary, secondary (atrial vs ventricular), and cardiovascular implantable electronic device related. 1 We are also aware that a notable percentage of patients who have undergone left-sided heart surgery will develop significant TR in their life span. 2 The exact prediction of patients at risk for this complication is being investigated, but an important study published recently 3 highlights that early tricuspid valve repair at the time of mitral surgery, even before severe TR has developed, is beneficial for long-term outcomes.…”

mentioning

confidence: 99%