Transcatheter Edge-to-Edge Repair in Patients With Complex Tricuspid Valve Anatomy.

IF 11.7 1区 医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS
David H Adams, Gilbert H L Tang, Brian K Whisenant, Susheel K Kodali, Gagan D Singh, Neil P Fam, Saibal Kar, Matthew J Price, Christian Spies, Jonathan G Schwartz, Raj R Makkar, Peter Tadros, Anita W Asgar, Ulrich P Jorde, Raymond L Benza, Vinod H Thourani, Patrick M McCarthy, Richard Bae, Thomas W R Smith, D Scott Lim, Moody M Makar, Hursh Naik, M Azeem Latib, Marta Sitges, Ralph Stephan von Bardeleben, Philipp Lurz, Nadira Hamid, Rebecca T Hahn, Paul Sorajja
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引用次数: 0

Abstract

Background: Untreated severe tricuspid regurgitation (TR) carries a poor prognosis.

Objectives: The authors report the 1-year outcomes of transcatheter edge-to-edge repair (TEER) with the TriClip system (Abbott Structural Heart) in patients with complex tricuspid valve anatomies.

Methods: The multicenter, international TRILUMINATE Pivotal (Trial to Evaluate Cardiovascular Outcomes in Patients Treated with the Tricuspid Valve Repair System Pivotal) trial included a single-arm cohort, with complex tricuspid valve anatomies excluded from the randomized arm (ie, anticipated TR reduction but not to moderate or less after TEER). The primary outcome endpoint of the single arm was 1-year survival with a Kansas City Cardiomyopathy Questionnaire score improvement ≥10 points.

Results: In the primary analysis population (N = 100), the mean age was 80 ± 6 years, and 35% had a cardiac implantable electronic device lead. Nearly 90% of patients had massive or torrential TR, 44% had prior left-sided valve interventions, 63% had ≥4-segmental tricuspid leaflet morphology, and the coaptation gap averaged 7.4 ± 2.7 mm. The primary endpoint was met (outcome: 46.2%, performance goal: 30%; P = 0.0008). A total of 81% of subjects had moderate or less TR at 1 year. No major adverse events or deaths occurred within 30 days postprocedure. One-year all-cause mortality and heart failure hospitalization were 15% and 24%, respectively. Significant improvements in NYHA functional class and Kansas City Cardiomyopathy Questionnaire overall scores occurred and were maintained at 1 year.

Conclusions: In patients with complex tricuspid anatomies, TEER with the TriClip system demonstrated excellent procedural safety with significant TR reduction and associated improvements in quality of life at 1 year.

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来源期刊
JACC. Cardiovascular interventions
JACC. Cardiovascular interventions CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
11.60
自引率
8.80%
发文量
756
审稿时长
4-8 weeks
期刊介绍: JACC: Cardiovascular Interventions is a specialist journal launched by the Journal of the American College of Cardiology (JACC). It covers the entire field of interventional cardiovascular medicine, including cardiac, peripheral, and cerebrovascular interventions. The journal publishes studies that will impact the practice of interventional cardiovascular medicine, including clinical trials, experimental studies, and in-depth discussions by respected experts. To enhance visual understanding, the journal is published both in print and electronically, utilizing the latest technologies.
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