Transcatheter Tricuspid Valve Interventions

Asmarats, Lluís; Puri, Rishi; Latib, Azeem; Navia, José L.; Rodés‐Cabau, Josep

doi:10.1016/j.jacc.2018.04.031

Cited by 234 publications

(93 citation statements)

References 69 publications

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“…Future studies are required to better understand which patients are ideal candidates for percutaneous annuloplasty. Patients with leaflet tethering, organic degeneration of the leaflets and TR secondary to partial interference of pacemaker leads are unlikely to derive significant benefit from an annuloplasty strategy ( 16 – 18 ). Echocardiographic predictors are required to discern those who will benefit the most from percutaneous annuloplasty.…”

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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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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“…The latter may indeed lead to an undertreated population with end-stage right heart failure, usually linked with hepatic congestion and/or late-stage kidney disease ( 3 , 4 ). As a result, the management of isolated TR represents an unmet clinical need that has led to the development of transcatheter tricuspid valve intervention (TTVI) ( 5 ). TTVI can be classified according to their mechanism of action as follows: annuloplasty devices, caval stent devices, tricuspid valve (TV) replacement, and coaptation devices.…”

Section: Introductionmentioning

confidence: 99%

“…TTVI can be classified according to their mechanism of action as follows: annuloplasty devices, caval stent devices, tricuspid valve (TV) replacement, and coaptation devices. The initial experience with these first-generation transcatheter systems showed that despite the high-risk profile of TR patients undergoing TTVI, the majority of the procedures were well-tolerated with low in-hospital mortality rates (lower than surgical series) ( 5 ). Among them, coaptation devices attempt to increase valve coaptation by leaflet plication or occupying the regurgitant orifice with a spacer.…”

Section: Introductionmentioning

confidence: 99%

Transcatheter Tricuspid Valve Intervention: Coaptation Devices

Muntané‐Carol

Alperi

Faroux

et al. 2020

Front. Cardiovasc. Med.

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Transcatheter tricuspid valve intervention (TTVI) has recently emerged as an alternative for the treatment of severe tricuspid regurgitation (TR). Multiple percutaneous devices have been developed in the last decade with promising early results. Among them, the coaptation devices are designed to reduce TR severity by valve leaflet plication or occupying the regurgitant orifice with a spacer. To date, the MitraClip/TriClip devices (Abbott, Santa Clara, CA, USA), the PASCAL system (Edwards Lifesciencies, Irvine, CA, USA), and the FORMA device (Edwards Lifesciencies, Irvine, CA, USA) have been used as coaptation devices for treating severe TR. The present document aimed to review the clinical evidence on coaptation devices in the field of TTVI, describing its design characteristics, main procedural steps, and early and mid-term outcomes.

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“…4 Several transcatheter therapies are currently in early clinical testing as an alternative treatment option for severe TR in elderly patients at high or prohibitive surgical risk and persisting symptoms of right heart failure despite optimal medical therapy. 5 Malnutrition and impairment of hepatic or renal function may complicate the clinical course of patients currently evaluated for transcatheter tricuspid valve therapies. However, the prevalence and clinical relevance of malnutrition as well as periprocedural changes in nutritional status or hepatorenal function in these patients have to date not been studied.…”

Section: Introductionmentioning

confidence: 99%

Nutritional status in tricuspid regurgitation: implications of transcatheter repair

Besler

Unterhuber

Rommel

et al. 2020

European J of Heart Fail

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Methods and results Overall, 86 consecutive patients (mean age 78 ± 7 years) with moderate-to-severe tricuspid regurgitation (TR) at prohibitive surgical risk were analysed. Mini Nutritional Assessment (MNA), quality of life assessment, 6-min walk test distance and laboratory analyses were performed before and 1 month after TTVR. A total of 43 patients (50%) underwent concomitant transcatheter mitral valve repair. According to MNA, 81 patients (94%) were malnourished or at risk of malnutrition before TTVR. Following TTVR, MNA improved in 64 patients (74%). As compared to patients without MNA improvement, patients with increased MNA score had greater reductions in TR [regurgitation volume −17.0 (interquartile range, IQR −25.0; −7.0) mL vs. −26.4 (IQR −40.3; −14.5) mL, P < 0.001] and inferior vena cava diameter. Only patients with increased MNA score displayed a decrease in N-terminal pro-brain natriuretic peptide levels [−320 (IQR −1294; 105) pg/mL vs. +708 (IQR −342; 2708) pg/mL, P = 0.009], improvements in cholinesterase levels (0.0 ± 11.9 μmoL/L vs. +10.9 ± 16.7 μmoL/L, P < 0.001) and renal function during follow-up. Beneficial effects on quality of life scores and 6-min walk test distance following TTVR were observed exclusively in patients with improvement in MNA. During a median follow-up of 6 months, patients with worsened MNA had an increased risk of death and rehospitalization for heart failure.

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Transcatheter Tricuspid Valve Interventions

Cited by 234 publications

References 69 publications

Future Perspectives in Percutaneous Treatment of Tricuspid Regurgitation

Future Perspectives in Percutaneous Treatment of Tricuspid Regurgitation

Transcatheter Tricuspid Valve Intervention: Coaptation Devices

Nutritional status in tricuspid regurgitation: implications of transcatheter repair

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