Echocardiographic Evaluation of Patients Undergoing Transcatheter Tricuspid Valve-In-Valve Replacement.
J Am Soc Echocardiogr
; 32(5): 616-623, 2019 05.
Article
en En
| MEDLINE
| ID: mdl-30773424
ABSTRACT
BACKGROUND:
Transcatheter tricuspid valve-in-valve replacement (TVIV) is an emerging therapy for dysfunctional surgical valves in patients with congenital and acquired TV disease. The present study was performed to establish baseline quantitative data for echocardiographic and invasive parameters obtained pre- and immediately post-TVIV.METHODS:
Patients were drawn from the VIVID Registry. This study included two cohorts. The registry cohort included all patients entered in the VIVID registry through February 2017 who had both echocardiographic and invasively measured gradients across the TV. The focused cohort comprised a subset of patients from a single institution who had both pre- and post-TVIV echocardiogram images reviewed offline by a single investigator. The echocardiographic variables measured were based on published guidelines from the American Society of Echocardiography.RESULTS:
Assessment of paired pre- and/or postimplant echocardiographic and invasive pressure measurements (n = 199) showed reasonable correlation between mean TV gradient measured invasively with cardiac catheterization and noninvasively both pre- and post-TVIV (R = 0.72, P < .001), although there was a bias toward the echocardiographic gradient being higher than the invasively measured gradient and sizable discrepancies were reported in several patients. In the focused cohort (n = 42), the mean TV inflow gradient was 9.3 ± 5.0 mm Hg pre- and 5.6 ± 2.3 mm Hg post-TVIV (P < .001). The TV pressure halftime and TVleft ventricular outflow tract Doppler velocity index were 215 ± 94 msec and 3.4 ± 1.2, respectively, at baseline, and 170 ± 44 msec and 2.4 ± 0.6 post-TVIV. Both the Doppler velocity index and the TV E velocity correlated with the mean TV inflow gradient.CONCLUSIONS:
This study provides benchmark data for the echocardiographic assessment of valve function after TVIV. In this population, the significance of an inflow gradient after TVIV should be interpreted in the clinical context. The appropriate threshold for defining dysfunction may differ from the levels proposed for assessment of native or newly placed surgical valves.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Insuficiencia de la Válvula Tricúspide
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Cateterismo Cardíaco
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Ecocardiografía Doppler
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Implantación de Prótesis de Válvulas Cardíacas
Tipo de estudio:
Guideline
Límite:
Adolescent
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Adult
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Aged
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Aged80
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Child
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
J Am Soc Echocardiogr
Asunto de la revista:
DIAGNOSTICO POR IMAGEM
Año:
2019
Tipo del documento:
Article