Alachkar Mhd Nawar, Schnupp Steffen, Eichelsdoerfer Astrid, Milzi Andrea, Mady Hesham, Salloum Basem, Bisht Osama, Cheikh-Ibrahim Mohammed, Forkmann Mathias, Krygier Lukas, Mahnkopf Christian
Department of Cardiology and Angiology, Regiomed Klinikum Coburg, 3396450 Coburg, Germany.
Department of Cardiology, Istituto Cardiocentro Ticino, 6900 Lugano, Switzerland.
J Clin Med. 2023 Jul 27;12(15):4930. doi: 10.3390/jcm12154930.
Transcatheter tricuspid valve repair using the edge-to-edge-technique (TEER) has emerged as an alternative therapy in patients with severe tricuspid regurgitation (TR) and high surgical risk. This study aimed to evaluate the feasibility and efficacy of tricuspid valve TEER in patients with cardiac implanted electric devices (CIEDs).
All patients who underwent tricuspid valve TEER at our center were retrospectively included. Patients were classified according to the presence of CIEDs. Procedure success was defined as implantation of at least one clip and the reduction of TR of at least one grade. Procedure success and intrahospital outcome were compared between the two groups.
One-hundred and six consecutive patients underwent tricuspid TEER (age 80.1 ± 6.4 years, male = 42; 39.6%). Among them, 25 patients (23.6%, age 80.6 ± 7.3 years, male = 14; 56%) had CIEDs. Patients with CIEDs had a significantly lower left ventricular ejection fraction (LV-EF) compared to those without CIEDs (47.2 ± 15% vs. 56.2 ± 8.2%, = 0.004, respectively). Moreover, arterial hypertension was more common in patients with CIEDs (96% vs. 79%, = 0.048). The success of the procedure did not differ between the non-CIED vs. CIED group (93.8% vs. 92%, = 0.748). Furthermore, the number and position of implanted clips, the duration of the procedure, the post-procedural pressure gradient across the tricuspid valve, and post-procedural TR severity were comparable between both groups.
Tricuspid valve TEER is feasible and efficient in patients with CIEDs. The success of the procedure, as well as the intrahospital outcome were comparable between patients with and without CIEDs.
使用边对边技术（TEER）的经导管三尖瓣修复术已成为严重三尖瓣反流（TR）且手术风险高的患者的一种替代治疗方法。本研究旨在评估心脏植入电子设备（CIED）患者进行三尖瓣TEER的可行性和疗效。
回顾性纳入在我们中心接受三尖瓣TEER的所有患者。根据是否存在CIED对患者进行分类。手术成功定义为植入至少一个夹子且TR降低至少一个等级。比较两组之间的手术成功率和院内结局。
106例连续患者接受了三尖瓣TEER（年龄80.1±6.4岁，男性42例；占39.6%）。其中，25例患者（23.6%，年龄80.6±7.3岁，男性14例；占56%）有CIED。与没有CIED的患者相比，有CIED的患者左心室射血分数（LV-EF）显著更低（分别为47.2±15%和56.2±8.2%，P = 0.004）。此外，CIED患者中动脉高血压更常见（96%对79%，P = 0.048）。非CIED组与CIED组之间手术成功率无差异（93.8%对92%，P = 0.748）。此外，两组之间植入夹子的数量和位置、手术持续时间、术后三尖瓣跨瓣压力梯度以及术后TR严重程度相当。
CIED患者进行三尖瓣TEER是可行且有效的。有CIED和没有CIED的患者之间手术成功率以及院内结局相当。
