Transcatheter Tricuspid Valve Intervention in Patients With Right Ventricular Dysfunction or Pulmonary Hypertension: Insights From the TriValve Registry
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Transcatheter Tricuspid Valve Intervention in Patients With Right Ventricular Dysfunction or Pulmonary Hypertension: Insights From the TriValve Registry. / Muntané-Carol, Guillem; Taramasso, Maurizio; Miura, Mizuki; Gavazzoni, Mara; Pozzoli, Alberto; Alessandrini, Hannes; Latib, Azeem; Attinger-Toller, Adrian; Biasco, Luigi; Braun, Daniel; Brochet, Eric; Connelly, Kim A; de Bruijn, Sabine; Denti, Paolo; Deuschl, Florian; Lubos, Edith; Ludwig, Sebastian; Kalbacher, Daniel; Estevez-Loureiro, Rodrigo; Fam, Neil; Frerker, Christian; Ho, Edwin; Juliard, Jean-Michel; Kaple, Ryan; Kodali, Susheel; Kreidel, Felix; Harr, Claudia; Lauten, Alexander; Lurz, Julia; Monivas, Vanessa; Mehr, Michael; Nazif, Tamin; Nickening, Georg; Pedrazzini, Giovanni; Philippon, François; Praz, Fabien; Puri, Rishi; Schäfer, Ulrich; Schofer, Joachim; Sievert, Horst; Tang, Gilbert H L; Khattab, Ahmed A; Andreas, Martin; Russo, Marco; Thiele, Holger; Unterhuber, Matthias; Himbert, Dominique; Urena, Marina; von Bardeleben, Ralph Stephan; Webb, John G; Weber, Marcel; Windecker, Stephan; Winkel, Mirjam; Zuber, Michel; Hausleiter, Jörg; Lurz, Philipp; Maisano, Francesco; Leon, Martin B; Hahn, Rebecca T; Rodés-Cabau, Josep; TriValve Registry.
in: CIRC-CARDIOVASC INTE, Jahrgang 14, Nr. 2, e009685, 02.2021.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Transcatheter Tricuspid Valve Intervention in Patients With Right Ventricular Dysfunction or Pulmonary Hypertension: Insights From the TriValve Registry
AU - Muntané-Carol, Guillem
AU - Taramasso, Maurizio
AU - Miura, Mizuki
AU - Gavazzoni, Mara
AU - Pozzoli, Alberto
AU - Alessandrini, Hannes
AU - Latib, Azeem
AU - Attinger-Toller, Adrian
AU - Biasco, Luigi
AU - Braun, Daniel
AU - Brochet, Eric
AU - Connelly, Kim A
AU - de Bruijn, Sabine
AU - Denti, Paolo
AU - Deuschl, Florian
AU - Lubos, Edith
AU - Ludwig, Sebastian
AU - Kalbacher, Daniel
AU - Estevez-Loureiro, Rodrigo
AU - Fam, Neil
AU - Frerker, Christian
AU - Ho, Edwin
AU - Juliard, Jean-Michel
AU - Kaple, Ryan
AU - Kodali, Susheel
AU - Kreidel, Felix
AU - Harr, Claudia
AU - Lauten, Alexander
AU - Lurz, Julia
AU - Monivas, Vanessa
AU - Mehr, Michael
AU - Nazif, Tamin
AU - Nickening, Georg
AU - Pedrazzini, Giovanni
AU - Philippon, François
AU - Praz, Fabien
AU - Puri, Rishi
AU - Schäfer, Ulrich
AU - Schofer, Joachim
AU - Sievert, Horst
AU - Tang, Gilbert H L
AU - Khattab, Ahmed A
AU - Andreas, Martin
AU - Russo, Marco
AU - Thiele, Holger
AU - Unterhuber, Matthias
AU - Himbert, Dominique
AU - Urena, Marina
AU - von Bardeleben, Ralph Stephan
AU - Webb, John G
AU - Weber, Marcel
AU - Windecker, Stephan
AU - Winkel, Mirjam
AU - Zuber, Michel
AU - Hausleiter, Jörg
AU - Lurz, Philipp
AU - Maisano, Francesco
AU - Leon, Martin B
AU - Hahn, Rebecca T
AU - Rodés-Cabau, Josep
AU - TriValve Registry
PY - 2021/2
Y1 - 2021/2
N2 - BACKGROUND: Scarce data exist on patients with right ventricular dysfunction (RVD) or pulmonary hypertension (PH) undergoing transcatheter tricuspid valve intervention. This study aimed to determine the early and midterm outcomes and the factors associated with mortality in this group of patients.METHODS: This subanalysis of the multicenter TriValve (Transcatheter Tricuspid Valve Therapies) registry included 300 patients with severe tricuspid regurgitation with RVD (n=244), PH (n=127), or both (n=71) undergoing transcatheter tricuspid valve intervention. RVD was defined as a tricuspid annular plane systolic excursion <17 mm, and PH as an estimated pulmonary artery systolic pressure ≥50 mm Hg.RESULTS: Mean age of the patients was 77±9 years (54% women). Procedural success was 80.7%, and 9 patients (3%) died during the hospitalization. At a median follow-up of 6 (interquartile range, 2-12) months, 54 patients (18%) died, and the independent associated factors were higher gamma-glutamyl transferase values at baseline (hazard ratio, 1.02 for each increase of 10 u/L [95% CI, 1.002-1.04]), poorer renal function defined as an estimated glomerular filtration rate <45 mL/min (hazard ratio, 2.3 [95% CI, 1.22-4.33]), and the lack of procedural success (hazard ratio, 2.11 [95% CI, 1.17-3.81]). The grade of RVD and the amount of PH at baseline were not found to be predictors of mortality. Most patients alive at follow-up improved their functional class (New York Heart Association I-II in 66% versus 7% at baseline, P<0.001).CONCLUSIONS: In patients with severe tricuspid regurgitation and RVD/PH, transcatheter tricuspid valve intervention was associated with high procedural success and a relatively low in-hospital mortality, along with significant improvements in functional status. However, about 1 out of 5 patients died after a median follow-up of 6 months, with hepatic congestion, renal dysfunction, and the lack of procedural success determining an increased risk. These results may improve the clinical evaluation of transcatheter tricuspid valve intervention candidates and would suggest a closer follow-up in those at increased risk. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT03416166.
AB - BACKGROUND: Scarce data exist on patients with right ventricular dysfunction (RVD) or pulmonary hypertension (PH) undergoing transcatheter tricuspid valve intervention. This study aimed to determine the early and midterm outcomes and the factors associated with mortality in this group of patients.METHODS: This subanalysis of the multicenter TriValve (Transcatheter Tricuspid Valve Therapies) registry included 300 patients with severe tricuspid regurgitation with RVD (n=244), PH (n=127), or both (n=71) undergoing transcatheter tricuspid valve intervention. RVD was defined as a tricuspid annular plane systolic excursion <17 mm, and PH as an estimated pulmonary artery systolic pressure ≥50 mm Hg.RESULTS: Mean age of the patients was 77±9 years (54% women). Procedural success was 80.7%, and 9 patients (3%) died during the hospitalization. At a median follow-up of 6 (interquartile range, 2-12) months, 54 patients (18%) died, and the independent associated factors were higher gamma-glutamyl transferase values at baseline (hazard ratio, 1.02 for each increase of 10 u/L [95% CI, 1.002-1.04]), poorer renal function defined as an estimated glomerular filtration rate <45 mL/min (hazard ratio, 2.3 [95% CI, 1.22-4.33]), and the lack of procedural success (hazard ratio, 2.11 [95% CI, 1.17-3.81]). The grade of RVD and the amount of PH at baseline were not found to be predictors of mortality. Most patients alive at follow-up improved their functional class (New York Heart Association I-II in 66% versus 7% at baseline, P<0.001).CONCLUSIONS: In patients with severe tricuspid regurgitation and RVD/PH, transcatheter tricuspid valve intervention was associated with high procedural success and a relatively low in-hospital mortality, along with significant improvements in functional status. However, about 1 out of 5 patients died after a median follow-up of 6 months, with hepatic congestion, renal dysfunction, and the lack of procedural success determining an increased risk. These results may improve the clinical evaluation of transcatheter tricuspid valve intervention candidates and would suggest a closer follow-up in those at increased risk. Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT03416166.
U2 - 10.1161/CIRCINTERVENTIONS.120.009685
DO - 10.1161/CIRCINTERVENTIONS.120.009685
M3 - SCORING: Journal article
C2 - 33541097
VL - 14
JO - CIRC-CARDIOVASC INTE
JF - CIRC-CARDIOVASC INTE
SN - 1941-7640
IS - 2
M1 - e009685
ER -