Transcatheter Repair for Tricuspid Regurgitation
Is transcatheter repair feasible for patients with severe tricuspid regurgitation (TR)?
This study examines the first-in-person experience with a novel transcatheter repair device that is designed to treat severe TR. This device was studied in seven high-risk patients with severe functional TR and clinical heart failure who were not thought to be surgical candidates; patients with leads in the right heart were excluded. This describes the clinical experience of these subjects.
Mean age was 76 ± 13 years. The device was successfully deployed in all seven patients without procedural complications. Degree of TR was reduced by at least one degree in all patients, and two degrees in four patients. Adverse events included new atrial fibrillation in one patient, minor bleeding and renal failure in one patient, and asymptomatic nonsustained ventricular tachycardia in one patient. At 30 days, all patients were alive with no additional complications. All but one patient had improved New York Heart Association functional class.
The authors concluded that transcatheter repair of severe TR appears feasible and has low rates of adverse events during short-term follow-up.
As transcatheter aortic valve replacement has grown in clinical use, there is increased interest in transcatheter treatment of other heart valve diseases. The optimal treatment for isolated severe functional TR remains controversial, and transcatheter repair may represent a promising option in some patients. This study is encouraging, although the results represent the outcomes of selected patients in the hands of highly experienced centers. Larger studies with longer-term follow-up are needed to determine the potential risks and durability of this procedure, and to determine whether this device improves clinical outcomes.
Clinical Topics: Arrhythmias and Clinical EP, Cardiac Surgery, Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Valvular Heart Disease, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Cardiac Surgery and Arrhythmias, Cardiac Surgery and Heart Failure, Cardiac Surgery and VHD, Acute Heart Failure, Interventions and Structural Heart Disease
Keywords: Atrial Fibrillation, Cardiac Surgical Procedures, Heart Failure, Heart Valve Diseases, Renal Insufficiency, Tachycardia, Ventricular, Transcatheter Aortic Valve Replacement, Transcatheter Cardiovascular Therapeutics, Tricuspid Valve Insufficiency
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