Cardiology Department, University Hospital Ramón y Cajal, Carretera de Colmenar Viejo, Km 9.1, Madrid, Spain.
Eur Heart J Cardiovasc Imaging. 2022 Jun 21;23(7):979-988. doi: 10.1093/ehjci/jeac079.
Severe tricuspid regurgitation (TR) has adverse effects on outcomes, with limited therapeutic options. We report the outcomes of patients undergoing percutaneous annuloplasty as a treatment of ≥severe functional TR in a single centre.
Prospective, single-arm, single-centre study that enrolled 24 consecutive patients with at least severe functional TR undergoing percutaneous annuloplasty with Cardioband system between 2019 and 2021. Clinical and echocardiographic data were prospectively collected, with a mean follow-up of 279 ± 246 days. At baseline, 66.6% were in New York Heart Association (NYHA) Classes III and IV and 100% had significant oedema. Technical success was 91.6%. At the end of follow-up, there was one death. Echocardiography showed a significant reduction in septolateral annular diameter of 10.4 mm (P < 0.001) that remained stable at the end of follow-up. The severity of the TR was also reduced. About 81.8% of patients were in NYHA Classes I and II. The number of patients with significant oedema decreased to 46% (P = 0.01). Six-minute walk distance improved by 68.8 m (P = 0.12).
Percutaneous annuloplasty with Cardioband system is an effective and safe treatment for patients with symptomatic, ≥severe functional TR. Annular reduction and TR severity reduction remained significant and sustained for 1 year. Patients experienced improvements in quality of life and exercise capacity.
严重三尖瓣反流(TR)对预后有不良影响,治疗选择有限。我们报告了在单一中心接受经皮瓣环成形术治疗至少重度功能性 TR 的患者的结局。
前瞻性、单臂、单中心研究,纳入了 2019 年至 2021 年间接受 Cardioband 系统行经皮瓣环成形术的 24 例至少重度功能性 TR 的连续患者。前瞻性收集临床和超声心动图数据,平均随访 279±246 天。基线时,66.6%的患者处于纽约心脏协会(NYHA)心功能分级 III 级和 IV 级,100%的患者有明显水肿。技术成功率为 91.6%。随访结束时,有 1 例死亡。超声心动图显示隔瓣环直径显著缩小 10.4mm(P<0.001),在随访结束时仍保持稳定。TR 的严重程度也有所减轻。约 81.8%的患者处于 NYHA 心功能分级 I 级和 II 级。有明显水肿的患者数量减少到 46%(P=0.01)。6 分钟步行距离增加了 68.8m(P=0.12)。
Cardioband 系统经皮瓣环成形术是治疗有症状、重度功能性 TR 的有效且安全的方法。瓣环缩小和 TR 严重程度减轻在 1 年内仍然显著且持续。患者的生活质量和运动能力得到改善。