Dataset Information

Transcatheter Tricuspid Repair for Tricuspid Regurgitation After Heart Transplantation.

ABSTRACT: A 67-year-old patient with history of heart transplantation was referred for symptomatic severe tricuspid regurgitation. Diagnostic workup showed chordal ruptures on the septal and anterior leaflets, most likely related to endomyocardial biopsies. Given the high surgical risk, the patient was treated percutaneously, with good results persisting at 3 months. (Level of Difficulty: Intermediate.).

SUBMITTER: Puscas T

PROVIDER: S-EPMC10119485 | biostudies-literature | 2023 Apr

REPOSITORIES: biostudies-literature

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Transcatheter Tricuspid Repair for Tricuspid Regurgitation After Heart Transplantation.

Puscas Tania T Gautier Charles-Henri CH Martin Anne-Céline AC Pechmajou Louis L Du Puy-Montbrun Leonora L Caudron Julia J Guillemain Romain R Bories Marie-Cécile MC Achouh Paul P Karam Nicole N

JACC. Case reports 20230419

A 67-year-old patient with history of heart transplantation was referred for symptomatic severe tricuspid regurgitation. Diagnostic workup showed chordal ruptures on the septal and anterior leaflets, most likely related to endomyocardial biopsies. Given the high surgical risk, the patient was treated percutaneously, with good results persisting at 3 months. (<b>Level of Difficulty: Intermediate.</b>). ...[more]

PMID: 37091057

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Project description:BackgroundEvidence is limited as to whether outcomes differ between patients with tricuspid regurgitation (TR) treated with tricuspid transcatheter edge-to-edge repair (T-TEER) versus surgical tricuspid valve repair. We aimed to compare outcomes between these 2 approaches.MethodsWe analyzed the data on Medicare fee-for-service beneficiaries aged 65 to 99 years with TR who underwent T-TEER or isolated surgical repair between July 2016 and December 2020. The primary outcome was 2-year all-cause mortality. Other outcomes included in-hospital mortality and permanent pacemaker implantation as well as 2-year heart failure hospitalization and tricuspid valve reintervention. A propensity score matching weight analysis was used to adjust for potential confounders.ResultsA total of 1143 patients were included (409 T-TEER versus 734 surgery). The proportion of T-TEER cases increased from 2% in the third quarter of 2016 to 67% in the last quarter of 2020 among all isolated TR procedures. After adjustment for potential confounders, we found no evidence that 2-year all-cause mortality differs between patients treated with T-TEER versus surgical repair (adjusted hazard ratio, 0.84 [95% CI, 0.63-1.13]). Patients treated with T-TEER experienced lower in-hospital mortality (2.5% versus 12.5%, P<0.001) and permanent pacemaker implantation rates (0.0% versus 12.7%, P<0.001) than those treated by surgical repair. At 2 years, we found no differences in heart failure hospitalizations, but tricuspid valve reinterventions were more frequent in the T-TEER group (subdistribution hazard ratio, 8.03 [95% CI, 2.87-22.48]).ConclusionsAmong Medicare beneficiaries with TR, the 2-year mortality rate was comparable between T-TEER and surgical repair. T-TEER showed advantages in perioperative outcomes, including lower in-hospital mortality and pacemaker implantation rates, whereas tricuspid valve reinterventions were more frequent in the T-TEER group. Further studies are necessary to refine indications, patient selections, and optimal timing for intervention with either treatment strategy.

Dataset Information

Transcatheter Tricuspid Repair for Tricuspid Regurgitation After Heart Transplantation.

Publications

Transcatheter Tricuspid Repair for Tricuspid Regurgitation After Heart Transplantation.

Similar Datasets

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