Transcatheter Therapy for the Tricuspid Valve: A Focused Review of Edge-to-Edge Repair and Orthotopic Valve Replacement.

IF 3.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Current Cardiology Reports Pub Date : 2024-06-01 Epub Date: 2024-06-17 DOI:10.1007/s11886-024-02051-4

Mahesh V Madhavan, Vratika Agarwal, Rebecca T Hahn

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Abstract

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. 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.

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三尖瓣经导管治疗：三尖瓣经导管疗法：边缘到边缘修补术和正位瓣膜置换术的重点回顾。

审查目的：患有严重三尖瓣反流（TR）的患者面临着巨大的发病率和死亡率风险。经导管三尖瓣介入治疗（TTVI）可为患者提供手术以外的微创治疗方法。本综述评估了目前全球用于治疗三尖瓣狭窄的最常见设备，即三尖瓣经导管边缘到边缘修补术（T-TEER）和正位经导管三尖瓣置换术（TTVR）：第一项关键性随机临床试验 TRILUMINATE 表明，T-TEER 可以安全地减少 TR，并能改善健康状况。然而，该试验的结果引发了人们的疑问，即该设备是否能充分减少 TR，从而影响临床效果。正位 TTVR 近来备受关注，其初步数据表明几乎可以完全消除 TR。本综述探讨了最常用的 T-TEER 和正位 TTVR 装置的技术特点和解剖局限性，讨论了这些装置目前的临床数据，并提供了选择装置的理论构架。

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来源期刊

Current Cardiology Reports CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

6.20

自引率

2.70%

发文量

209

期刊介绍： The aim of this journal is to provide timely perspectives from experts on current advances in cardiovascular medicine. We also seek to provide reviews that highlight the most important recently published papers selected from the wealth of available cardiovascular literature. We accomplish this aim by appointing key authorities in major subject areas across the discipline. Section editors select topics to be reviewed by leading experts who emphasize recent developments and highlight important papers published over the past year. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research. We also provide commentaries from well-known figures in the field.