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Purpose of Review Patients with severe tricuspid regurgitation (TR) are at risk for significant morbidity and mortality. Transcatheter tricuspid valve interventions (TTVI) may offer patients less invasive treatment alternatives to surgery. This review evaluates the most common class of device currently used worldwide to treat TR, tricuspid transcatheter edge-to-edge repair (T-TEER) and orthotopic transcatheter tricuspid valve replacement (TTVR), both of which are now approved in the USA and Europe. Recent Findings The first pivotal randomized clinical trial, TRILUMINATE, demonstrated that T-TEER can safely reduce TR and is associated with improved health status outcomes. However, results of this trial have raised questions about whether this device can provide sufficient TR reduction to impact clinical outcomes. Orthotopic TTVR has recently gained attention with initial data suggesting near-complete TR elimination. Summary The current review examines the technical features and anatomic limitations of the most commonly used devices for T-TEER and orthotopic TTVR, discusses the current clinical data for these devices, and offers a theoretical construct for device selection.
Purpose of Review Patients with severe tricuspid regurgitation (TR) are at risk for significant morbidity and mortality. Transcatheter tricuspid valve interventions (TTVI) may offer patients less invasive treatment alternatives to surgery. This review evaluates the most common class of device currently used worldwide to treat TR, tricuspid transcatheter edge-to-edge repair (T-TEER) and orthotopic transcatheter tricuspid valve replacement (TTVR), both of which are now approved in the USA and Europe. Recent Findings The first pivotal randomized clinical trial, TRILUMINATE, demonstrated that T-TEER can safely reduce TR and is associated with improved health status outcomes. However, results of this trial have raised questions about whether this device can provide sufficient TR reduction to impact clinical outcomes. Orthotopic TTVR has recently gained attention with initial data suggesting near-complete TR elimination. Summary The current review examines the technical features and anatomic limitations of the most commonly used devices for T-TEER and orthotopic TTVR, discusses the current clinical data for these devices, and offers a theoretical construct for device selection.
Introducción: El corazón forma parte del sistema cardiovascular y posee cuatro válvulas; la tricúspide, la pulmonar, la mitral y la aórtica. Las condiciones que afectan a la fisiología de la válvula tricúspide son originadas por patologías genéticas o adquiridas y se clasifican en estenosis e insuficiencia tricúspide, los grupos más vulnerables son las mujeres, adultos mayores y personas que tengan comorbilidades de cardiopatía izquierda, los síntomas más comunes son: hepatoesplenomegalia, ascitis, astenia, disnea y edema. Objetivo: Determinar el manejo de Insuficiencia tricúspide en un caso clínico para presentar aspectos nuevos e instructivos de la enfermedad. Metodología: La dirección metodológica utilizada en este estudio es de revisión y análisis de caso clínico. Resultados: Una persona de sexo femenino de 74 años diagnosticada de cardiopatía congénita y valvular no dilatada con función sistólica conservada, FEVI 67% tratada con cierre quirúrgico de comunicación interauricular e insuficiencia tricúspide severa sintomática con fibrilación auricular, el objetivo de este estudio es determinar el manejo de la insuficiencia tricúspide y presentar aspectos nuevos o instructivos de la enfermedad con sus respectivos antecedentes, historia clínica, examen físico, tratamiento quirúrgico, plan de atención de enfermería y evolución con la finalidad de ampliar los conocimientos del personal de salud, comunidad científica y público general. Conclusión: La ET es una condición valvular de poco impacto en la población general, a diferencia de la IT que el porcentaje de prevalencia es más alto, por lo regular, comparten de manera similar el cuadro clínico, el diagnóstico y el tratamiento. Área de estudio general: medicina. Área de estudio específica: cardiología. Tipo de estudio: Casos clínicos.
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