Leaflet Morphology and its Implications for Direct Transcatheter Annuloplasty of Tricuspid Regurgitation
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Leaflet Morphology and its Implications for Direct Transcatheter Annuloplasty of Tricuspid Regurgitation. / Körber, Maria Isabel; Roder, Fabian; Gerçek, Muhammed; Koell, Benedikt; Kalbacher, Daniel; Iliadis, Christos; Brüwer, Monique; Friedrichs, Kai Peter; Rudolph, Volker; Baldus, Stephan; Pfister, Roman.
in: JACC-CARDIOVASC INTE, Jahrgang 16, Nr. 6, 27.03.2023, S. 693-702.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Leaflet Morphology and its Implications for Direct Transcatheter Annuloplasty of Tricuspid Regurgitation
AU - Körber, Maria Isabel
AU - Roder, Fabian
AU - Gerçek, Muhammed
AU - Koell, Benedikt
AU - Kalbacher, Daniel
AU - Iliadis, Christos
AU - Brüwer, Monique
AU - Friedrichs, Kai Peter
AU - Rudolph, Volker
AU - Baldus, Stephan
AU - Pfister, Roman
N1 - Copyright © 2023 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
PY - 2023/3/27
Y1 - 2023/3/27
N2 - BACKGROUND: Leaflet morphology has been associated with treatment success in edge-to-edge repair of tricuspid regurgitation (TR), but the impact on annuloplasty is unclear.OBJECTIVES: The authors sought to examine the association of leaflet morphology with efficacy and safety of direct annuloplasty in TR.METHODS: The authors analyzed patients who underwent catheter-based direct annuloplasty with the Cardioband at 3 centers. Leaflet morphology was assessed according to number and location of leaflets by echocardiography. Patients with simple morphology (2 or 3 leaflets) were compared with complex morphology (>3 leaflets).RESULTS: The study included 120 patients (median age 80 years) with ≥severe TR. A total of 48.3% of patients had a 3-leaflet morphology, 5% a 2-leaflet morphology, and 46.7% had >3 tricuspid leaflets. Baseline characteristics did not differ relevantly between groups except for a higher incidence of torrential TR grade (50 vs 26.6%) in complex morphologies. Postprocedural improvement of 1 (90.6% vs 92.9%) and 2 (71.9% vs 67.9%) TR grades was not significantly different between groups, but patients with complex morphology had more often residual TR ≥3 at discharge (48.2 vs 26.6%; P = 0.014). This difference did not remain significant (P = 0.112) after adjusting for baseline TR severity, coaptation gap, and nonanterior jet localization. Safety endpoints including complications of the right coronary artery, and technical success did not show significant differences.CONCLUSIONS: Efficacy and safety of transcatheter direct annuloplasty using Cardioband are not affected by leaflet morphology. Assessment of leaflet morphology should be part of procedural planning in patients with TR and might help to individually tailor repair techniques to patient anatomy.
AB - BACKGROUND: Leaflet morphology has been associated with treatment success in edge-to-edge repair of tricuspid regurgitation (TR), but the impact on annuloplasty is unclear.OBJECTIVES: The authors sought to examine the association of leaflet morphology with efficacy and safety of direct annuloplasty in TR.METHODS: The authors analyzed patients who underwent catheter-based direct annuloplasty with the Cardioband at 3 centers. Leaflet morphology was assessed according to number and location of leaflets by echocardiography. Patients with simple morphology (2 or 3 leaflets) were compared with complex morphology (>3 leaflets).RESULTS: The study included 120 patients (median age 80 years) with ≥severe TR. A total of 48.3% of patients had a 3-leaflet morphology, 5% a 2-leaflet morphology, and 46.7% had >3 tricuspid leaflets. Baseline characteristics did not differ relevantly between groups except for a higher incidence of torrential TR grade (50 vs 26.6%) in complex morphologies. Postprocedural improvement of 1 (90.6% vs 92.9%) and 2 (71.9% vs 67.9%) TR grades was not significantly different between groups, but patients with complex morphology had more often residual TR ≥3 at discharge (48.2 vs 26.6%; P = 0.014). This difference did not remain significant (P = 0.112) after adjusting for baseline TR severity, coaptation gap, and nonanterior jet localization. Safety endpoints including complications of the right coronary artery, and technical success did not show significant differences.CONCLUSIONS: Efficacy and safety of transcatheter direct annuloplasty using Cardioband are not affected by leaflet morphology. Assessment of leaflet morphology should be part of procedural planning in patients with TR and might help to individually tailor repair techniques to patient anatomy.
KW - Humans
KW - Aged, 80 and over
KW - Tricuspid Valve Insufficiency/diagnostic imaging
KW - Treatment Outcome
KW - Tricuspid Valve/diagnostic imaging
KW - Mitral Valve/surgery
KW - Echocardiography/adverse effects
U2 - 10.1016/j.jcin.2023.01.364
DO - 10.1016/j.jcin.2023.01.364
M3 - SCORING: Journal article
C2 - 36990560
VL - 16
SP - 693
EP - 702
JO - JACC-CARDIOVASC INTE
JF - JACC-CARDIOVASC INTE
SN - 1936-8798
IS - 6
ER -