Invasive Hemodynamic Characteristics in Patients Undergoing Transcatheter Tricuspid Valve-In-Valve Implantation for Treatment of Tricuspid Stenosis.
World J Pediatr Congenit Heart Surg
; 11(4): 411-416, 2020 07.
Article
en En
| MEDLINE
| ID: mdl-32645780
ABSTRACT
BACKGROUND:
We sought to describe invasive hemodynamic measurements in patients with tricuspid stenosis (TS) undergoing transcatheter tricuspid valve-in-valve (TVIV) implantation immediately pre- and postimplantation. Development of TS in patients who have undergone surgical tricuspid valve replacement with a bioprosthetic valve is a serious complication that leads to elevated right atrial (RA) pressures and decreased cardiac output. Transcatheter TVIV implantation is a viable alternative to surgical tricuspid valve replacement, but data on the hemodynamic consequences of TVIV for the treatment of severe TS are currently limited to echocardiographic assessment of Doppler-derived gradients.METHODS:
Eleven patients undergoing transcatheter TVIV implantation with moderate to severe bioprosthetic valve stenosis were selected for retrospective review. Right atrial mean pressure, right ventricular (RV) systolic and end-diastolic pressure, mean diastolic RA-RV pressure gradient, pulmonary artery capillary wedge pressure, pulmonary artery systolic, end-diastolic and mean pressures, and pulmonary artery pulsatility index (PAPi) both before and after transcatheter valve placement were collected from catheterization reports.RESULTS:
After transcatheter TVIV implantation, the mean TS gradient decreased significantly (P < .01), while the mean RV end-diastolic pressure increased (P = .046). Pulmonary artery pulsatility index also increased as the TS was relieved (P = .039).CONCLUSIONS:
Tricuspid valve-in-valve implantation results in immediate relief of TS, leading to increased RV preload with resultant augmentation of RV and pulmonary pressures. Increased PAPi following the procedure demonstrates acute improvement in RV output but remains low due to the failure of the RA pressure to decline significantly immediately following intervention.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Válvula Tricúspide
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Estenosis de la Válvula Tricúspide
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Cateterismo Cardíaco
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Monitoreo Intraoperatorio
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Implantación de Prótesis de Válvulas Cardíacas
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Hemodinámica
Tipo de estudio:
Diagnostic_studies
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Observational_studies
Límite:
Adult
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Female
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Humans
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Male
Idioma:
En
Revista:
World J Pediatr Congenit Heart Surg
Año:
2020
Tipo del documento:
Article
País de afiliación:
Estados Unidos