Cumitini Luca, Giubertoni Ailia, Mennuni Marco Giovanni, Degiovanni Anna, Patti Giuseppe
Department of Translational Medicine, University of Eastern Piedmont, Via Solaroli 17, Novara 28100, Italy.
Department of Thoracic and Cardiovascular Diseases, Maggiore della Carità Hospital, Via Mazzini 18, Novara 28100, Italy.
Eur Heart J Case Rep. 2024 Mar 5;8(3):ytae102. doi: 10.1093/ehjcr/ytae102. eCollection 2024 Mar.
Tricuspid regurgitation (TR) is common and severe or greater TR is linked to poor prognosis. Treatment of TR with transcatheter edge-to-edge repair has emerged as a safe and potentially effective therapy in these patients. However, the impact of transcatheter tricuspid repair on functional capacity remains to be elucidated.
We describe the case of a 77-year-old woman complaining of heart failure symptoms, undergoing transcatheter edge-to-edge valve repair for severe TR with the PASCAL Ace® device. One month later, cardiopulmonary exercise testing (CPET) showed significant improvement in peak O uptake and O pulse compared with the test performed before the procedure.
A positive impact of novel transcatheter edge-to-edge valve repair on symptoms and quality of life in patients with severe or greater TR at prohibitive surgical risk has recently emerged. The presence of severe TR has prognostic relevance, and novel percutaneous tricuspid valve repair systems have emerged in the last few years. Cardiopulmonary exercise testing is an established tool to assess functional capacity and prognosis in heart failure patient. Detecting functional capacity improvement after transcatheter edge-to-edge repair for severe TR can be challenging, and CPET may arise as a promising tool to help these purposes.
三尖瓣反流（TR）很常见，严重的TR或更严重的TR与不良预后相关。经导管缘对缘修复治疗TR已成为这些患者的一种安全且可能有效的治疗方法。然而，经导管三尖瓣修复对功能能力的影响仍有待阐明。
我们描述了一名77岁女性的病例，该患者主诉心力衰竭症状，使用PASCAL Ace®装置对严重TR进行经导管缘对缘瓣膜修复。一个月后，心肺运动试验（CPET）显示与手术前进行的测试相比，峰值摄氧量和氧脉搏有显著改善。
新型经导管缘对缘瓣膜修复对手术风险极高的严重或更严重TR患者的症状和生活质量有积极影响，这一点最近已显现出来。严重TR的存在具有预后相关性，并且在过去几年中出现了新型经皮三尖瓣修复系统。心肺运动试验是评估心力衰竭患者功能能力和预后的既定工具。检测严重TR经导管缘对缘修复后的功能能力改善可能具有挑战性，而CPET可能成为实现这些目标的一种有前景的工具。
