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Transcatheter tricuspid valve replacement in patients with severe tricuspid regurgitation.
Lu, Fang-Lin; An, Zhao; Ma, Ye; Song, Zhi-Gang; Cai, Cheng-Liang; Li, Bai-Ling; Zhou, Guang-Wei; Han, Lin; Wang, Jun; Bai, Yi-Fan; Liu, Xiao-Hong; Wang, Jia-Feng; Meng, Xu; Zhang, Hai-Bo; Yang, Jian; Dong, Nian-Guo; Hu, Sheng-Shou; Pan, Xiang-Bin; Cheung, Anson; Qiao, Fan; Xu, Zhi-Yun.
Afiliação
  • Lu FL; Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
  • An Z; Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
  • Ma Y; Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
  • Song ZG; Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
  • Cai CL; Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
  • Li BL; Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
  • Zhou GW; Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
  • Han L; Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
  • Wang J; Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
  • Bai YF; Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
  • Liu XH; Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
  • Wang JF; Department of Anesthesiology and Intensive Care, Changhai Hospital, Second Military Medical University, Shanghai, China.
  • Meng X; Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing, China.
  • Zhang HB; Department of Cardiac Surgery, Beijing An Zhen Hospital, Capital Medical University, Beijing, China.
  • Yang J; Department of Cardiovascular Surgery, Xijing Hospital, The Air Force Medical University, Xi'an, China.
  • Dong NG; Department of Cardiovascular Surgery, Wuhan Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
  • Hu SS; Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
  • Pan XB; Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
  • Cheung A; Division of Cardiothoracic Surgery, St. Paul's Hospital, University of British Columbia, Vancouver, British Columbia, Canada.
  • Qiao F; Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China zhiyunxu@yeah.net qiaofan@smmu.edu.cn.
  • Xu ZY; Department of Cardiovascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China zhiyunxu@yeah.net qiaofan@smmu.edu.cn.
Heart ; 107(20): 1664-1670, 2021 10.
Article em En | MEDLINE | ID: mdl-33419880
ABSTRACT

OBJECTIVE:

Tricuspid regurgitation (TR) is a common valvular heart disease with unsatisfactory medical therapeutics and high surgical mortality. The present study aims to evaluate the safety and effectiveness of transcatheter tricuspid valve replacement (TTVR) in high-risk patients with severe TR.

METHODS:

This was a compassionate multicentre study. Between September 2018 and November 2019, 46 patients with TR who were not suitable for surgery received compassionate TTVR under general anaesthesia and the guidance of trans-oesophageal echocardiography and fluoroscopy in four institutions. Access to the tricuspid valve was obtained via a minimally invasive thoracotomy and transatrial approach. Patients' data at baseline, before discharge, 30 days and 6 months after the procedure were collected.

RESULTS:

All patients had severe TR with vena contracta width of 12.6 (11.0, 14.5) mm. Procedural success (97.8%) was achieved in all but one case with right ventricle perforation. The procedural time was 150.0 (118.8, 180.0) min. Intensive care unit time was 2.0 (1.0, 4.0) days. 6-month mortality was 17.4%. Device migration occurred in one patient (2.4%) during follow-up. Transthoracic echocardiography at 6 months after operation showed TR was significantly reduced (none/trivial in 33, mild in 4 and moderate in 1) and the primary safety end point was achieved in 38 cases (82.6%). Patients suffered from peripheral oedema and ascites decreased from 100.0% and 47.8% at baseline to 2.6% and 0.0% at 6 months.

CONCLUSIONS:

The present study showed TTVR was feasible, safe and with low complication rates in patients with severe TR.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Valva Tricúspide / Insuficiência da Valva Tricúspide / Cateterismo Cardíaco / Implante de Prótese de Valva Cardíaca / Recuperação de Função Fisiológica Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Guideline / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Heart Assunto da revista: CARDIOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: China

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Valva Tricúspide / Insuficiência da Valva Tricúspide / Cateterismo Cardíaco / Implante de Prótese de Valva Cardíaca / Recuperação de Função Fisiológica Tipo de estudo: Clinical_trials / Diagnostic_studies / Etiology_studies / Guideline / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Heart Assunto da revista: CARDIOLOGIA Ano de publicação: 2021 Tipo de documento: Article País de afiliação: China