Transcatheter tricuspid valve repair/replacement

2021 ◽  
pp. 361-376
Author(s):  
Rebecca T. Hahn
Keyword(s):  
Tricuspid Valve ◽  
High Mortality ◽  
Tricuspid Regurgitation ◽  
Complex Disease ◽  
Disease Process ◽  
Tricuspid Valve Repair ◽  
Disease States ◽  
Functional Tricuspid Regurgitation ◽  
High Prevalence ◽  
The Impact

Given the high prevalence of significant functional tricuspid regurgitation (TR) in a number of disease states, as well as the impact of TR on mortality, interest has grown in refining the diagnosis and treatment, with hopes of improving outcomes. Surgical intervention has been associated with high mortality and limited improvement in mortality resulting in a need for less invasive alternatives. The current chapter reviews the new percutaneous options for treatment of TR by looking at the pertinent surgical literature, reviewing the relevant anatomic, discussing the strengths and pitfalls of imaging this complex disease process and finally reviewing important device design that may influence device choice.

scholarly journals Functional tricuspid regurgitation, related right heart remodeling, and available treatment options: good news for patients with heart failure?

2021 ◽  
Author(s):  
Marijana Tadic ◽  
Cesare Cuspidi ◽  
Daniel Armando Morris ◽  
Wolfang Rottbauer
Keyword(s):  
Heart Failure ◽  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Right Atrial ◽  
Functional Mitral Regurgitation ◽  
Tricuspid Valve Repair ◽  
Right Heart ◽  
Heart Remodeling ◽  
Functional Tricuspid Regurgitation ◽  
Patients With Heart Failure

AbstractSignificant functional tricuspid regurgitation (FTR) represents a poor prognostic factor independent of right ventricular (RV) function. It is usually the consequence of left-sided cardiac diseases that induce RV dilatation and dysfunction, but it can also resulted from right atrial (RA) enlargement and consequent tricuspid annular dilatation. FTR is very frequent among patients with heart failure, particularly in those with reduced LVEF and concomitant functional mitral regurgitation. The development of three-dimensional echocardiography enabled detailed assessment of tricuspid valve anatomy, subvavlular apparatus, and RA and RV changes, as well as accurate evaluation of FTR etiology. Due to high in-hospital mortality risk in patients who were operatively treated for isolated FTR, it has been treated only medically for a long time. Percutaneous approach considers mainly transcatheter tricuspid valve repair (edge-to-edge and annuloplasty) and represents a very attractive option for the high-risk patients. Studies that investigated the effects of different devices showed excellent feasibility and safety, followed by significant reduction in FTR grade, improvement in functional capacity and NYHA class, quality of life, and reduction in hospitalization due to heart failure. Some investigations also reported a decreased mortality in FTR patients. Nevertheless, the results of these investigations should be interpreted with cautious due to the small number of participants and relatively short follow-up. The aim of this review was to summarize the existing data about the clinical importance of FTR and FTR-induced right heart remodeling and currently existing therapeutic approaches for treatment of FTR.

scholarly journals Ring, Band or Suture in Tricuspid Annuloplasty for Functional Tricuspid Regurgitation; Which is Better and More Durable?

2019 ◽  
Vol 22 (5) ◽  
pp. E411-E415 ◽  
Author(s):  
Ahmed Adas ◽  
Ahmed Elnaggar ◽  
Yehia Balbaa ◽  
Ahmed Elashkar ◽  
Hesham Mostafa Alkady
Keyword(s):  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Late Results ◽  
Tricuspid Valve Repair ◽  
Recurrence Rates ◽  
Vena Contracta ◽  
Functional Tricuspid Regurgitation ◽  
Tricuspid Incompetence ◽  
Group B

Background: In this study, we evaluate different annuloplasty modalities to repair functional tricuspid regurgitation. Patients and methods: Between January 2011 and January 2017, 200 patients with moderate or greater functional tricuspid regurgitation received tricuspid valve repair as part of primary surgeries on the left side of their cardiac valves. Of these, 39 patients received rings (Group A), 84 patients received bands (Group B), and 77 patients received suture annuloplasty (Group C). Results: Two patients from Group C were operated on again, during the primary hospital stay due to severe symptomatic tricuspid regurgitation. The degrees of early postoperative tricuspid regurgitation – mean vena contracta and mean jet area – significantly were higher in Group C. During a mean follow-up period of 26 ± 12.6 months, 5 patients within Group C (6.85%) and one patient in Group B (1.3%) were operated on again with tricuspid valve replacement due to severe symptomatic tricuspid incompetence. Also during follow up, mean degrees of tricuspid regurgitation, mean vena contracta, and mean jet areas significantly were higher in Group C. Conclusion: Patients who received rings followed by band annuloplasty had better early and late results with lower recurrence rates than those who received suture annuloplasty

Residual Tricuspid Regurgitation following Tricuspid Valve Repair during Concomitant Valve Surgery Worsens Late Survival

2015 ◽  
Vol 18 (6) ◽  
pp. 226 ◽  
Author(s):  
Robert A. Sorabella ◽  
Erin Mamuyac ◽  
Halit Yerebakan ◽  
Marc Najjar ◽  
Vivian Choi ◽  
...  
Keyword(s):  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Subgroup Analysis ◽  
Cohort Analysis ◽  
Valve Surgery ◽  
Tricuspid Valve Repair ◽  
Valve Repair ◽  
The Impact ◽  
Late Survival

<strong>Background:</strong> Concomitant tricuspid valve repair (TVr) for functional tricuspid regurgitation (TR) at the time of left-sided valve surgery has become increasingly more common over the past decade. The impact of residual post-repair TR on late outcomes remains unclear.<br /><strong>Methods:</strong> All patients undergoing TVr during concomitant left-sided valve surgery at our institution from 2005-2012 were retrospectively reviewed. Patients were stratified into 2 groups according to the degree of post-cardiopulmonary bypass TR observed on intraoperative transesophageal echocardiography; 0-1+ TR (No TR, n = 246) and ≥2+ TR (Residual TR, n = 26). Primary outcomes of interest were 30-day survival, 4-year survival, and follow-up TR grade. A propensity-matched subgroup analysis was performed in addition to the overall cohort analysis.<br /><strong>Results:</strong> Mean age for all patients was 70.3 ± 13.0 years and 107 (39%) patients were male. There was no difference in 30-day survival between groups (92% No TR versus 96% Residual TR, P = .70). Kaplan-Meier analysis of overall 4-year survival showed a trend toward worsened survival in the Residual TR group (log rank P = .17) and propensity-matched subgroup analysis showed significantly worse 4-year survival for Residual TR (log rank P = .02). At mean echocardiographic follow up of 11.9 ± 22.5 months, TR grade was significantly worse in the Residual TR group compared to No TR (1.5 ± 0.8 Residual TR versus 0.9 ± 0.9 No TR, <br />P = .005), although TR severity was significantly improved from immediately post-bypass. <br /><strong>Conclusions:</strong> Patients left with residual TR following TVr during concomitant left-sided valve surgery have significantly decreased late survival compared to patients left with no post-repair TR.

scholarly journals Aetiology‐based clinical scenarios predict outcomes of transcatheter edge‐to‐edge tricuspid valve repair of functional tricuspid regurgitation

2019 ◽  
Vol 21 (9) ◽  
pp. 1117-1125 ◽  
Author(s):  
Florian Schlotter ◽  
Mathias Orban ◽  
Karl‐Philipp Rommel ◽  
Christian Besler ◽  
Maximilian Roeder ◽  
...  
Keyword(s):  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Tricuspid Valve Repair ◽  
Valve Repair ◽  
Functional Tricuspid Regurgitation ◽  
Clinical Scenarios

scholarly journals Echocardiographic study of functional tricuspid regurgitation and results of tricuspid valve repair

2018 ◽  
Vol 26 (3) ◽  
pp. 163-170
Author(s):  
Javid Raja ◽  
Vivek Jaswal ◽  
Shyam Kumar Singh Thingnam ◽  
Harkant Singh ◽  
Goverdhan Dutt Puri ◽  
...  
Keyword(s):  
Tricuspid Valve ◽  
Tricuspid Regurgitation ◽  
Tricuspid Valve Repair ◽  
Valve Repair ◽  
Functional Tricuspid Regurgitation ◽  
Echocardiographic Study
Sign in / Sign up

Export Citation Format

Share Document