1-Year Outcomes After Edge-to-Edge Valve Repair for Symptomatic Tricuspid Regurgitation: Results From the TriValve Registry
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1-Year Outcomes After Edge-to-Edge Valve Repair for Symptomatic Tricuspid Regurgitation: Results From the TriValve Registry. / Mehr, Michael; Taramasso, Maurizio; Besler, Christian; Ruf, Tobias; Connelly, Kim A; Weber, Marcel; Yzeiraj, Ermela; Schiavi, Davide; Mangieri, Antonio; Vaskelyte, Laura; Alessandrini, Hannes; Deuschl, Florian; Brugger, Nicolas; Ahmad, Hasan; Biasco, Luigi; Orban, Mathias; Deseive, Simon; Braun, Daniel; Rommel, Karl-Philipp; Pozzoli, Alberto; Frerker, Christian; Näbauer, Michael; Massberg, Steffen; Pedrazzini, Giovanni; Tang, Gilbert H L; Windecker, Stephan; Schäfer, Ulrich; Kuck, Karl-Heinz; Sievert, Horst; Denti, Paolo; Latib, Azeem; Schofer, Joachim; Nickenig, Georg; Fam, Neil; von Bardeleben, Stephan; Lurz, Philipp; Maisano, Francesco; Hausleiter, Jörg.
in: JACC-CARDIOVASC INTE, Jahrgang 12, Nr. 15, 12.08.2019, S. 1451-1461.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - 1-Year Outcomes After Edge-to-Edge Valve Repair for Symptomatic Tricuspid Regurgitation: Results From the TriValve Registry
AU - Mehr, Michael
AU - Taramasso, Maurizio
AU - Besler, Christian
AU - Ruf, Tobias
AU - Connelly, Kim A
AU - Weber, Marcel
AU - Yzeiraj, Ermela
AU - Schiavi, Davide
AU - Mangieri, Antonio
AU - Vaskelyte, Laura
AU - Alessandrini, Hannes
AU - Deuschl, Florian
AU - Brugger, Nicolas
AU - Ahmad, Hasan
AU - Biasco, Luigi
AU - Orban, Mathias
AU - Deseive, Simon
AU - Braun, Daniel
AU - Rommel, Karl-Philipp
AU - Pozzoli, Alberto
AU - Frerker, Christian
AU - Näbauer, Michael
AU - Massberg, Steffen
AU - Pedrazzini, Giovanni
AU - Tang, Gilbert H L
AU - Windecker, Stephan
AU - Schäfer, Ulrich
AU - Kuck, Karl-Heinz
AU - Sievert, Horst
AU - Denti, Paolo
AU - Latib, Azeem
AU - Schofer, Joachim
AU - Nickenig, Georg
AU - Fam, Neil
AU - von Bardeleben, Stephan
AU - Lurz, Philipp
AU - Maisano, Francesco
AU - Hausleiter, Jörg
N1 - Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
PY - 2019/8/12
Y1 - 2019/8/12
N2 - OBJECTIVES: The purpose of this study was to evaluate procedural and 1-year clinical and echocardiographic outcomes of patients treated with tricuspid edge-to-edge repair.BACKGROUND: Transcatheter edge-to-edge repair has been successfully performed in selected patients with symptomatic tricuspid regurgitation (TR) and high risk for surgery, but outcome data are sparse.METHODS: This analysis of the multicenter international TriValve (Transcatheter Tricuspid Valve Therapies) registry included 249 patients with severe TR treated with edge-to-edge repair in compassionate and/or off-label use. Clinical and echocardiographic outcomes were prospectively collected and retrospectively analyzed.RESULTS: In 249 patients (mean age 77 ± 9 years; European System for Cardiac Operative Risk Evaluation II score 6.4% [interquartile range: 3.9% to 13.9%]), a successful procedure with TR reduction to grade ≤2+ was achieved in 77% by placement of 2 ± 1 tricuspid clips. Concomitant treatment of severe TR and mitral regurgitation was performed in 52% of patients. At 1-year follow-up, significant and durable improvements in TR severity (TR ≤2+ in 72% of patients) and New York Heart Association functional class (≤II in 69% of patients) were observed. All-cause mortality was 20%, and the combined rate of mortality and unplanned hospitalization for heart failure was 35%. Predictors of procedural failure included effective regurgitant orifice area, tricuspid coaptation gap, tricuspid tenting area, and absence of central or anteroseptal TR jet location. Predictors of 1-year mortality were procedural failure, worsening kidney function, and absence of sinus rhythm.CONCLUSIONS: Transcatheter tricuspid edge-to-edge repair can achieve TR reduction at 1 year, resulting in significant clinical improvement. Predictors of procedural failure and 1-year mortality identified here may help select patients who will benefit most from this therapy.
AB - OBJECTIVES: The purpose of this study was to evaluate procedural and 1-year clinical and echocardiographic outcomes of patients treated with tricuspid edge-to-edge repair.BACKGROUND: Transcatheter edge-to-edge repair has been successfully performed in selected patients with symptomatic tricuspid regurgitation (TR) and high risk for surgery, but outcome data are sparse.METHODS: This analysis of the multicenter international TriValve (Transcatheter Tricuspid Valve Therapies) registry included 249 patients with severe TR treated with edge-to-edge repair in compassionate and/or off-label use. Clinical and echocardiographic outcomes were prospectively collected and retrospectively analyzed.RESULTS: In 249 patients (mean age 77 ± 9 years; European System for Cardiac Operative Risk Evaluation II score 6.4% [interquartile range: 3.9% to 13.9%]), a successful procedure with TR reduction to grade ≤2+ was achieved in 77% by placement of 2 ± 1 tricuspid clips. Concomitant treatment of severe TR and mitral regurgitation was performed in 52% of patients. At 1-year follow-up, significant and durable improvements in TR severity (TR ≤2+ in 72% of patients) and New York Heart Association functional class (≤II in 69% of patients) were observed. All-cause mortality was 20%, and the combined rate of mortality and unplanned hospitalization for heart failure was 35%. Predictors of procedural failure included effective regurgitant orifice area, tricuspid coaptation gap, tricuspid tenting area, and absence of central or anteroseptal TR jet location. Predictors of 1-year mortality were procedural failure, worsening kidney function, and absence of sinus rhythm.CONCLUSIONS: Transcatheter tricuspid edge-to-edge repair can achieve TR reduction at 1 year, resulting in significant clinical improvement. Predictors of procedural failure and 1-year mortality identified here may help select patients who will benefit most from this therapy.
KW - Aged
KW - Aged, 80 and over
KW - Cardiac Catheterization/adverse effects
KW - Compassionate Use Trials
KW - Europe
KW - Female
KW - Heart Valve Prosthesis
KW - Heart Valve Prosthesis Implantation/adverse effects
KW - Hemodynamics
KW - Humans
KW - Male
KW - North America
KW - Recovery of Function
KW - Registries
KW - Retrospective Studies
KW - Risk Factors
KW - Severity of Illness Index
KW - Time Factors
KW - Treatment Outcome
KW - Tricuspid Valve/diagnostic imaging
KW - Tricuspid Valve Insufficiency/diagnostic imaging
U2 - 10.1016/j.jcin.2019.04.019
DO - 10.1016/j.jcin.2019.04.019
M3 - SCORING: Journal article
C2 - 31395215
VL - 12
SP - 1451
EP - 1461
JO - JACC-CARDIOVASC INTE
JF - JACC-CARDIOVASC INTE
SN - 1936-8798
IS - 15
ER -