Transcatheter Tricuspid Valve Repair With the PASCAL System

Fam, Neil; Ho, Edwin; Zahrani, Mohammed; Samargandy, Sondos; Connelly, Kim A.

doi:10.1016/j.jcin.2017.12.004

Cited by 68 publications

(20 citation statements)

References 3 publications

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“…The PASCAL device has also been successfully adapted from mitral to tricuspid use in one case report [75]. However, data regarding its safety and efficacy are lacking.…”

Section: Transcatheter Tricuspid Valve Therapiesmentioning

confidence: 99%

Advances in transcatheter mitral and tricuspid therapies

Overtchouk

Piazza

Granada

et al. 2020

BMC Cardiovasc Disord

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Background: While rheumatic mitral stenosis has been effectively treated percutaneously for more than 20 years, mitral and tricuspid regurgitation treatment appear as a contemporary unmet need. The advent of transcatheter therapies offer new treatment options to often elderly and frail patients at high risk for open surgery. We aimed at providing an updated review of fast-growing domain of transcatheter mitral and tricuspid technology. Main body: We reviewed the existing literature on mitral and tricuspid transcatheter therapies. Mitraclip is becoming an established therapy for secondary mitral regurgitation in selected patients with disproportionately severe regurgitation associated with moderate left ventricle dysfunction. Evidence is less convincing for primary mitral regurgitation. Transcatheter mitral valve replacement is a promising emerging alternative to transcatheter repair, for secondary as well as primary mitral regurgitation. But further development is needed to improve delivery. Transcatheter tricuspid intervention arrives late after similar technologies have been developed for aortic and mitral valves and is currently at its infancy. This is likely due in part to previously under-recognized impact of tricuspid regurgitation on patient outcomes. Edge-to-edge repair is the most advanced transcatheter solution in development. Data on tricuspid annuloplasty and replacement is limited, and more research is warranted. Conclusion: The future appears bright for transcatheter mitral therapies, albeit their place in clinical practice is yet to be clearly defined. Tricuspid transcatheter therapies might address the unmet need of tricuspid regurgitation treatment.

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“…The PASCAL device has also been successfully adapted from mitral to tricuspid use in one case report [75]. However, data regarding its safety and efficacy are lacking.…”

Section: Transcatheter Tricuspid Valve Therapiesmentioning

confidence: 99%

Advances in transcatheter mitral and tricuspid therapies

Overtchouk

Piazza

Granada

et al. 2020

BMC Cardiovasc Disord

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“…17 Fam et al recently reported a case of an 82-year-old woman with torrential TR who underwent successful TTVI using the PASCAL system. 18 Early feasibility study is an ongoing multicenter trial. c. Intravascular coaptation device: The FORMA repair system (Edwards Lifesciences) is designed for patients with a severe functional TR.…”

Section: Transcatheter Tv Interventionsmentioning

confidence: 99%

Evaluation and Management of Primary Tricuspid Regurgitation

Sudhakar

2020

Indian Journal of Clinical Cardiology

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Tricuspid regurgitation (TR) is a highly prevalent echocardiographic finding in general population being present in almost 80% to 90% of them. However, TR is mild or functional rather than organic in majority of people. Significant TR was seen in 14.8% of adult men and 18.4% of adult women, respectively. Of all the significant TRs, approximately 8% to 10% are primary. Mild TR is benign but moderate-to-severe TR tends to progress and carries significant morbidity and mortality. Tricuspid valve disease is either primary or secondary (functional) in nature. Valve leaflets are predominantly diseased in primary TR, whereas annular dilatation is the main culprit in secondary TR. Of all the heart valves, tricuspid valve was the most neglected valve till a decade ago, though there was enough evidence to show that moderate to severe TR was not as benign as was assumed. With the availability of 2-dimensional echocardiography (2D echo) and transesophageal echocardiography, we are able to diagnose and determine the severity as well as etiology of TR. Although surgical therapy remains the gold standard for severe primary tricuspid valve disease, it continues to suffer from one of the highest morbidity and mortality rates among all cardiac valve-related surgeries even in the hands of experienced surgeons. For the same reason, majority of patients are not referred or subjected to surgical therapy. Therefore, there is an unmet need for less invasive and safer form of therapy to overcome this hurdle. So, several less-invasive and innovative technologies for treating patients with severe tricuspid valve disease at high surgical risk are being developed. Some of them have already been used for treatment of severe mitral regurgitation. They are being adopted for the treatment of severe TR. This review provides a comprehensive picture of newer guidelines and latest technologies and their impact on diagnosis and outcome of high-risk TV disease.

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“…The first case of the Pascal system in the tricuspid position was reported in early 2018 and, recently, a case series of 12 patients was presented. [28–30] In seven patients, two devices were implanted; four patients received one device and one procedure was unsuccessful because of imaging problems. TR reduction of ≥1 grade was achieved in 92% in the six patients, which persisted at 30-day follow-up.…”

Section: Repairmentioning

confidence: 99%

Update on the Current Landscape of Transcatheter Options for Tricuspid Regurgitation Treatment

et al. 2019

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Most patients with severe tricuspid regurgitation lack treatment options because of prohibitive surgical risk. New transcatheter treatments under development and investigation might be able to address this unmet clinical need. This article gives an update on the landscape of devices for transcatheter tricuspid regurgitation treatment including different approaches (i.e. repair with leaflet approximation or annuloplasty and replacement using orthotopic or heterotopic valves) at different stages of development, from experimental to clinical trial. Repair devices such as the Cardioband or the MitraClip are leading the field with promising preliminary data and further trials are ongoing. However, with implantations of the Gate bioprosthesis, replacement devices are catching up. Potential advantages of different approaches and most recent data are discussed.

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Transcatheter Tricuspid Valve Repair With the PASCAL System

Cited by 68 publications

References 3 publications

Advances in transcatheter mitral and tricuspid therapies

Advances in transcatheter mitral and tricuspid therapies

Evaluation and Management of Primary Tricuspid Regurgitation

Update on the Current Landscape of Transcatheter Options for Tricuspid Regurgitation Treatment

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