Efficacy of the transcatheter tricuspid valve replacement for patients with severe tricuspid regurgitation: Lux-Valve versus Lux-Valve Plus.

Abstract

Objectives: To compare the efficacy of transcatheter tricuspid valve replacement (TTVR) using Lux-Valve and Lux-Valve Plus in patients with severe tricuspid regurgitation.

Methods: A total of 28 consecutive patients with severe tricuspid regurgitation who underwent TTVR with Lux-Valve (n=14) or Lux-Valve Plus (n=14) in the First Affiliated Hospital of the Air Force Medical University from August 2019 to November 2023 were enrolled. Transthoracic echocardiography was performed in all the patients before and 6 months after TTVR. The ultrasound indexes were compared before and 6 months after TTVR in all patients and between Lux-Valve and Lux-Valve Plus groups.

Results: Intraoperative bleeding was significantly reduced, and length postoperative hospital stay was significantly shorter in the Lux-Valve Plus group compared with those in the Lux-Valve group (both P<0.05). Six months after TTVR, none of the patients exhibited more than mild tricuspid valve regurgitation, and none of the patients had moderate or above perivalvular leakage except for one patient in the Lux-Valve Plus group who had a separation of the clamping member from the anterior tricuspid leaflet. The incidence of perivalvular leakage was significantly lower in the Lux-Valve Plus group (14.29%, 2/14) compared with the Lux-Valve group (64.29%, 9/14, P<0.05). At 6 months after operation, the right chamber volume and right ventricle middle transverse diameter were reduced; the peak blood flow velocity across the tricuspid valve, peak pressure gradient across the tricuspid valve, mean blood flow velocity of tricuspid valve, mean pressure gradient across the tricuspid valve and velocity time integral were increased in both groups (all P<0.05). The left ventricular ejection fraction was higher in the Lux-Valve Plus group at 6 months postoperatively compared with the Lux-Valve group (P<0.05), while the rest of the indicators were not statistically different between the groups (all P>0.05).

Conclusions: The efficacy of using Lux-Valve and Lux-Valve Plus for TTVR in patients with severe tricuspid regurgitation is comparable. Six months after TTVR, the right heart has undergone reverse remodeling. Although Lux-Valve Plus is more minimally invasive, the characteristics of the device and follow patient individualization should be taken into account when selecting a valve.