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Expert opinion
Published online: 2021-10-05
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Percutaneous tricuspid edge-to-edge repair — patient selection, imaging considerations, and the procedural technique. Expert opinion of the Working Group on Echocardiography and Association of CardioVascular Interventions of the Polish Cardiac Society

Adam Rdzanek1, Piotr Szymański2, Andrzej Gackowski3, Piotr Scisło1, Jerzy Pręgowski4, Arkadiusz Pietrasik1, Jarosław Trębacz5, Karol Zbroński1, Janusz Kochman1, Adam Witkowski4, Wojciech Wojakowski6, Marek Grygier7
DOI: 10.33963/KP.a2021.0125
·
Pubmed: 34611879
Affiliations
  1. 1st Department of Cardiology, Medical University of Warsaw, Warszawa, Poland
  2. Clinical Cardiology Center, Central Clinical Hospital of theMinistry of the Interior in Warsaw and Center of Postgraduate Medical Education, Warszawa, Poland
  3. Jagiellonian University, Medical College, Institute of Cardiology, Department of Coronary Disease and Heart Failure, Noninvasive Cardiovascular Laboratory, John Paul II Hospital, Kraków, Poland
  4. Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warszawa, Poland
  5. Department of Interventional Cardiology and Angiology, Institute of Cardiology, Warszawa, Poland
  6. Department of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
  7. 1st Department of Cardiology, Poznan University of Medical Sciences, Poznań, Poland

open access

Online first
Expert opinion and position paper
Published online: 2021-10-05

Abstract

Tricuspid regurgitation (TR) is a common acquired valvular heart disease (VHD). TR has progressive character and is associated with impaired long-term survival in both symptomatic and asymptomatic subjects. Despite this knowledge, the overall number of tricuspid valve surgeries is very low worldwide and many patients with clear indications for intervention are left untreated. The development of less invasive transcatheter techniques may offer new treatment options in this growing population of patients. Out of various percutaneous methods proposed, tricuspid edge-to-edge repair has recently gained considerable attention. The article summarizes available data regarding this new treatment method.

Abstract

Tricuspid regurgitation (TR) is a common acquired valvular heart disease (VHD). TR has progressive character and is associated with impaired long-term survival in both symptomatic and asymptomatic subjects. Despite this knowledge, the overall number of tricuspid valve surgeries is very low worldwide and many patients with clear indications for intervention are left untreated. The development of less invasive transcatheter techniques may offer new treatment options in this growing population of patients. Out of various percutaneous methods proposed, tricuspid edge-to-edge repair has recently gained considerable attention. The article summarizes available data regarding this new treatment method.

Get Citation
About this article
Title

Percutaneous tricuspid edge-to-edge repair — patient selection, imaging considerations, and the procedural technique. Expert opinion of the Working Group on Echocardiography and Association of CardioVascular Interventions of the Polish Cardiac Society

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Expert opinion

Published online

2021-10-05

DOI

10.33963/KP.a2021.0125

Pubmed

34611879

Authors

Adam Rdzanek
Piotr Szymański
Andrzej Gackowski
Piotr Scisło
Jerzy Pręgowski
Arkadiusz Pietrasik
Jarosław Trębacz
Karol Zbroński
Janusz Kochman
Adam Witkowski
Wojciech Wojakowski
Marek Grygier

References (34)
  1. Topilsky Y, Maltais S, Medina Inojosa J, et al. Burden of tricuspid regurgitation in Patients diagnosed in the community setting. JACC Cardiovasc Imaging. 2019; 12(3): 433–442.
  2. Silbiger JJ. Atrial functional tricuspid regurgitation: an underappreciated cause of secondary tricuspid regurgitation. Echocardiography. 2019; 36(5): 954–957.
  3. Shiran A, Sagie A. Tricuspid regurgitation in mitral valve disease incidence, prognostic implications, mechanism, and management. J Am Coll Cardiol. 2009; 53(5): 401–408.
  4. Bannehr M, Edlinger CR, Kahn U, et al. Natural course of tricuspid regurgitation and prognostic implications. Open Heart. 2021; 8(1): e001529.
  5. Topilsky Y, Nkomo VT, Vatury O, et al. Clinical outcome of isolated tricuspid regurgitation. JACC Cardiovasc Imaging. 2014; 7(12): 1185–1194.
  6. Wang N, Fulcher J, Abeysuriya N, et al. Tricuspid regurgitation is associated with increased mortality independent of pulmonary pressures and right heart failure: a systematic review and meta-analysis. Eur Heart J. 2019; 40(5): 476–484.
  7. Bartko P, Arfsten H, Frey M, et al. Natural history of functional tricuspid regurgitation: implications of quantitative Doppler assessment. JACC: Cardiovascular Imaging. 2019; 12(3): 389–397.
  8. Schueler R, Öztürk C, Sinning JM, et al. Impact of baseline tricuspid regurgitation on long-term clinical outcomes and survival after interventional edge-to-edge repair for mitral regurgitation. Clin Res Cardiol. 2017; 106(5): 350–358.
  9. Geyer M, Keller K, Bachmann K, et al. Concomitant tricuspid regurgitation severity and its secondary reduction determine long-term prognosis after transcatheter mitral valve edge-to-edge repair. Clin Res Cardiol. 2021; 110(5): 676–688.
  10. Wengenmayer T, Zehender M, Bothe W, et al. First transfemoral percutaneous edge-to-edge repair of the tricuspid valve using the MitraClip system. EuroIntervention. 2016; 11(13): 1541–1544.
  11. Nickenig G, Kowalski M, Hausleiter J, et al. Transcatheter treatment of severe tricuspid regurgitation with the edge-to-edge MitraClip technique. Circulation. 2017; 135(19): 1802–1814.
  12. Orban M, Rommel KP, Ho EC, et al. Transcatheter edge-to-edge tricuspid repair for severe tricuspid regurgitation reduces hospitalizations for heart failure. JACC Heart Fail. 2020; 8(4): 265–276.
  13. Cai S, Bowers N, Dhoot A, et al. Natural history of severe tricuspid regurgitation: outcomes after transcatheter tricuspid valve intervention compared to medical therapy. Int J Cardiol. 2020; 320: 49–54.
  14. Vahanian A, Beyersdorf F, Praz F, et al. ESC/EACTS Scientific Document Group. 2021 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2021 [Epub ahead of print]: 30660536.
  15. Otto CM, Nishimura RA, Bonow RO, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. Circulation. 2021; 143(5): e35–e71.
  16. Mehr M, Karam N, Taramasso M, et al. Combined tricuspid and mitral versus isolated mitral valve repair for severe MR and TR: an analysis from the TriValve and TRAMI registries. JACC: Cardiovascular Interventions. 2020; 13(5): 543–550.
  17. Taramasso M, Hahn RT, Alessandrini H, et al. The international multicenter TriValve registry: which patients are undergoing transcatheter tricuspid repair? JACC Cardiovasc Interv. 2017; 10(19): 1982–1990.
  18. McCarthy PM, Bhudia SK, Rajeswaran J, et al. Tricuspid valve repair: durability and risk factors for failure. J Thorac Cardiovasc Surg. 2004; 127(3): 674–685.
  19. Hahn RT, Zamorano JL. The need for a new tricuspid regurgitation grading scheme. Eur Heart J Cardiovasc Imaging. 2017; 18(12): 1342–1343.
  20. Otto CM, Nishimura R, Bonow R, et al. 2020 ACC/AHA guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Joint Committee on Cinical Practice Guidelines. Circulation. 2021; 143(5): e72–e227.
  21. Hahn RT. A review of imaging options relevant to treating functional tricuspid regurgitation with transcatheter techniques. Cardiac Interventions Today. 2017; 11(4): 40–47.
  22. Instructions for Use TriclipTM System. https://vascular.eifu.abbott/en/detail-screen.html (May 6, 2021).
  23. Instructions for use Edwards PASCAL Transcatheter Valve Repair System. https://eifu.edwards.com/eifu/pages/viewers/pdf?projectKey=5e7e4f5d87b3940001e289be&itemKey=605bd73ab4147f0001900c76 (May 6, 2021).
  24. Karam N, Mehr M, Taramasso M, et al. Value of echocardiographic right ventricular and pulmonary pressure assessment in predicting transcatheter tricuspid repair outcome. JACC Cardiovasc Interv. 2020; 13(10): 1251–1261.
  25. Besler C, Orban M, Rommel KP, et al. Predictors of procedural and clinical outcomes in patients with symptomatic tricuspid regurgitation undergoing transcatheter edge-to-edge repair. JACC Cardiovasc Interv. 2018; 11(12): 1119–1128.
  26. Mehr M, Taramasso M, Besler C, et al. 1-Year outcomes after edge-to-edge valve repair for symptomatic tricuspid regurgitation: results from the TriValve registry. JACC Cardiovasc Interv. 2019; 12(15): 1451–1461.
  27. Taramasso M, Alessandrini H, Latib A, et al. Outcomes after current transcatheter tricuspid valve intervention: mid-term results from the international TriValve registry. JACC Cardiovasc Interv. 2019; 12(2): 155–165.
  28. Nickenig G, Weber M, Lurz P, et al. Transcatheter edge-to-edge repair for reduction of tricuspid regurgitation: 6-month outcomes of the TRILUMINATE single-arm study. Lancet. 2019; 394(10213): 2002–2011.
  29. Lurz P, Stephan von Bardeleben R, Weber M, et al. TRILUMINATE Investigators. Transcatheter edge-to-edge repair for treatment of tricuspid regurgitation. J Am Coll Cardiol. 2021; 77(3): 229–239.
  30. Praz F, Spargias K, Chrissoheris M, et al. Compassionate use of the PASCAL transcatheter mitral valve repair system for patients with severe mitral regurgitation: a multicentre, prospective, observational, first-in-man study. Lancet. 2017; 390(10096): 773–780.
  31. Lim DS, Kar S, Spargias K, et al. Transcatheter valve repair for patients with mitral regurgitation: 30-day results of the CLASP study. JACC Cardiovasc Interv. 2019; 12(14): 1369–1378.
  32. Webb JG, Hensey M, Szerlip M, et al. 1-year outcomes for transcatheter repair in patients with mitral regurgitation from the CLASP study. JACC Cardiovasc Interv. 2020; 13(20): 2344–2357.
  33. Fam NP, Braun D, von Bardeleben RS, et al. Compassionate use of the PASCAL transcatheter valve repair system for severe tricuspid regurgitation: a multicenter, observational, first-in-human experience. JACC Cardiovasc Interv. 2019; 12(24): 2488–2495.
  34. Kodali S, Hahn RT, Eleid MF, et al. CLASP TR EFS Investigators. Feasibility study of the transcatheter valve repair system for severe tricuspid regurgitation. J Am Coll Cardiol. 2021; 77(4): 345–356.

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