Transcatheter Tricuspid Valve Intervention in Patients With Previous Left Valve Surgery

Guillem Muntané-Carol, Maurizio Taramasso, Mizuki Miura, Mara Gavazzoni, Alberto Pozzoli, Hannes Alessandrini, Azeem Latib, Adrian Attinger-Toller, Luigi Biasco, Daniel Braun, Eric Brochet, Kim A. Connelly, Horst Sievert, Paolo Denti, Edith Lubos, Sebastian Ludwig, Daniel Kalbacher, Rodrigo Estevez-Loureiro, Neil Fam, Christian FrerkerEdwin Ho, Jean Michel Juliard, Ryan Kaple, Susheel Kodali, Felix Kreidel, Claudia Harr, Alexander Lauten, Julia Lurz, Karl Patrik Kresoja, Vanessa Monivas, Michael Mehr, Tamim Nazif, Georg Nickening, Giovanni Pedrazzini, François Philippon, Fabien Praz, Rishi Puri, Ulrich Schäfer, Joachim Schofer, Gilbert H.L. Tang, Ahmed A. Khattab, Martin Andreas, Marco Russo, Holger Thiele, Matthias Unterhuber, Dominique Himbert, Marina Urena, Ralph Stephan von Bardeleben, John G. Webb, Marcel Weber, Mirjam Winkel, Michel Zuber, Jörg Hausleiter, Philipp Lurz, Francesco Maisano, Martin B. Leon, Rebecca T. Hahn, Josep Rodés-Cabau

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Background: Scarce data exist on patients with previous left valve surgery (PLVS) undergoing transcatheter tricuspid valve intervention (TTVI). This study sought to investigate the procedural and early outcomes in patients with PLVS undergoing TTVI. Methods: This was a subanalysis of the multicenter TriValve registry including 462 patients, 82 (18%) with PLVS. Data were analyzed according to the presence of PLVS in the overall cohort and in a propensity score–matched population including 51 and 115 patients with and without PLVS, respectively. Results: Patients with PLVS were younger (72 ± 10 vs 78 ± 9 years; p < 0.01) and more frequently female (67.1% vs 53.2%; P = 0.02). Similar rates of procedural success (PLVS 80.5%; no-PLVS 82.1%; P = 0.73), and 30-day mortality (PLVS 2.4%, no-PLVS 3.4%; P = 0.99) were observed. After matching, there were no significant differences in both all-cause rehospitalisation (PLVS 21.1%, no-PLVS 26.5%; P = 0.60) and all-cause mortality (PLVS 9.8%, no-PLVS 6.7%; P = 0.58). At last follow-up (median 6 [interquartile range 1-12] months after the procedure), most patients (81.8%) in the PLVS group were in NYHA functional class I-II (P = 0.12 vs no-PLVS group), and TR grade was ≤ 2 in 82.6% of patients (P = 0.096 vs no-PVLS group). A poorer right ventricular function and previous heart failure hospitalization determined increased risks of procedural failure and poorer outcomes at follow-up, respectively. Conclusions: In patients with PLVS, TTVI was associated with high rates of procedural success and low early mortality. However, about one-third of patients required rehospitalisation or died at midterm follow-up. These results would support TTVI as a reasonable alternative to redo surgery in patients with PLVS and suggest the importance of earlier treatment to improve clinical outcomes.

Original languageEnglish (US)
Pages (from-to)1094-1102
Number of pages9
JournalCanadian Journal of Cardiology
Volume37
Issue number7
DOIs
StatePublished - Jul 2021
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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