Early Multinational Experience of Transcatheter Tricuspid Valve Replacement for Treating Severe Tricuspid Regurgitation

Rebecca T. Hahn, Susheel Kodali, Neil Fam, Vinayak Bapat, Krzysztof Bartus, Josep Rodés-Cabau, Francois Dagenais, Rodrigo Estevez-Loureiro, Alberto Forteza, Samir Kapadia, Azeem Latib, Francesco Maisano, Patrick McCarthy, Jose Navia, Geraldine Ong, Mark Peterson, George Petrossian, Alberto Pozzoli, Markus Reinartz, Mark J. RicciardiNewell Robinson, Horst Sievert, Maurizio Taramasso, Vratika Agarwal, Elisabeth Bédard, Giuseppe Tarantini, Andrea Colli

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Objectives: The aim of this registry was to evaluate the feasibility and safety of transcatheter tricuspid valve implantation (TTVI) in patients with extreme surgical risk. Background: Isolated tricuspid regurgitation (TR) surgery is associated with high in-hospital mortality. Methods: Thirty consecutive patients (mean age 75 ± 10 years; 56% women) from 10 institutions, with symptomatic functional TR, had institutional and notified body approval for compassionate use of the GATE TTVI system. Baseline, discharge, and 30-day follow-up echocardiographic data and procedural, in-hospital, and follow-up clinical outcomes were collected. Results: At baseline, all patients had multiple comorbidities, severe or greater TR, and reduced baseline right ventricular function. Technical success was achieved in 26 of 30 patients (87%). Device malpositioning occurred in 4 patients, with conversion to open heart surgery in 2 (5%). Of those who received the device, 100% had reductions in TR of ≥1, and 75% experienced reductions of ≥2 grades, resulting in 18 of 24 of patients (76%) with mild or less TR at discharge. All patients had mild or less central TR. There was continued improvement in TR grade between discharge and 30 days in 15 of 19 patients (79%). In-hospital mortality was 10%. At mean follow-up of 127 ± 82 days, 4 patients (13%) had died. Of patients alive at follow-up, 62% were in New York Heart Association functional class I or II, with no late device-related adverse events. Conclusions: Compassionate treatment of severe, symptomatic functional TR using a first-generation TTVI device is associated with significant reduction in TR and improvement in functional status with acceptable in-hospital mortality. Further studies are needed to determine the appropriate patient population and long-term outcomes with TTVI therapy.

Original languageEnglish (US)
Pages (from-to)2482-2493
Number of pages12
JournalJACC: Cardiovascular Interventions
Volume13
Issue number21
DOIs
StatePublished - Nov 9 2020

Keywords

  • tricuspid regurgitation
  • tricuspid valve
  • valve replacement

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint

Dive into the research topics of 'Early Multinational Experience of Transcatheter Tricuspid Valve Replacement for Treating Severe Tricuspid Regurgitation'. Together they form a unique fingerprint.

Cite this