Cepas-Guillen Pedro Luis, de la Fuente Mancera Juan Carlos, Guzman Bofarull Joan, Farrero Marta, Regueiro Ander, Brugaletta Salvatore, Ibañez Cristina, Sanchis Laura, Sitges Marta, Sabate Manel, Freixa Xavier
Cardiology Department, Cardiovascular Institute (ICCV), Hospital Clinic, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain.
Anesthesiology Department, Hospital Clinic, IDIBAPS, University of Barcelona, 08036 Barcelona, Spain.
J Clin Med. 2021 Sep 19;10(18):4252. doi: 10.3390/jcm10184252.
Transcatheter tricuspid valve repair (TTVr) has emerged as an alternative for the treatment of severe tricuspid regurgitation (TR). We report our initial experience with an edge-to-edge TTVr system in a high-volume institution.
We included consecutive patients who underwent edge-to-edge TTVr systems. The primary efficacy endpoint was a reduction in the TR of at least one grade. The primary safety endpoint was procedure-related clinical serious adverse events.
A total of 28 patients underwent TTVr with edge-to-edge systems. All patients presented with at least severe TR with a high impact on quality of life (82% of patients in NYHA class ≥ III). The Triclip system was the most used device (89%). The primary efficacy endpoint was met in all patients. Only one patient experienced a procedural complication (femoral pseudoaneurysm). At three-month follow-up, 83% of patients were in NYHA I or II (18% baseline vs. 83% 3 months follow-up; < 0.001). Echocardiography follow-up showed residual TR ≤ 2 in 79% of patients (paired < 0.001). At the maximum follow-up (median follow up = 372 days), no patients had died.
Edge-to-edge TTVr systems seem to represent a very valid alternative to prevent morbidity and mortality associated with TR as depicted by the favorable efficacy and safety.
经导管三尖瓣修复术（TTVr）已成为治疗严重三尖瓣反流（TR）的一种替代方法。我们报告了在一家大型机构中使用缘对缘TTVr系统的初步经验。
我们纳入了连续接受缘对缘TTVr系统治疗的患者。主要疗效终点是TR至少降低一个等级。主要安全终点是与手术相关的临床严重不良事件。
共有28例患者接受了缘对缘系统的TTVr治疗。所有患者均表现为至少严重TR，对生活质量有很大影响（82%的患者纽约心脏协会（NYHA）心功能分级≥III级）。Triclip系统是使用最多的器械（89%）。所有患者均达到主要疗效终点。只有1例患者出现手术并发症（股动脉假性动脉瘤）。在3个月的随访中，83%的患者NYHA心功能分级为I级或II级（基线时为18%，随访3个月时为83%；P<0.001）。超声心动图随访显示，79%的患者残余TR≤2级（配对P<0.001）。在最长随访期（中位随访时间=372天），无患者死亡。
缘对缘TTVr系统似乎是预防与TR相关的发病率和死亡率的一种非常有效的替代方法，其疗效和安全性良好。
