Sazzad Faizus, Zhu Yinling, Leo Hwa Liang, Nah Jie Hui, Ang Hui Ying, Lee Chuen Neng, Hon Jimmy Kim Fatt
Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, 117597 Singapore, Singapore.
Department of Biomedical Engineering, College of Design and Engineering, National University of Singapore, 117583 Singapore, Singapore.
Rev Cardiovasc Med. 2023 Aug 11;24(8):231. doi: 10.31083/j.rcm2408231. eCollection 2023 Aug.
Intervention for tricuspid regurgitation (TR) tends to happen concurrently with and is addressed during mitral valve surgery. Isolated TR interventions, however, are not unusual and are becoming more common. The purpose of this study was to provide a general overview of the transcatheter tricuspid valve implantation (TTVI) devices, taking into account the several design variations, and to unify the implantation technique, existing clinical results, and potential future directions for TR replacement therapy.
The major databases, namely Pubmed via Medline, Embase, and Cochrane library, were systematically searched from the date of conception until 10 February 2023, in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) standards.
Eleven studies were isolated from a total cohort of 5842 publications. All the transcatheter tricuspid prostheses were circular in design yet categorized into annular tricuspid valve implantation (ATVI) and caval valve implantation (CAVI) groups. Bleeding (25.2%), severe access site and vascular issues requiring intervention (5.8%), device migration or embolization (3.6%), and paravalvular leak (38%) are among the early TTVI-related complications that have been observed. The CAVI group experienced 3 of 28 bleeding cases and 2 of 4 device migration cases.
Following the intervention with a transcatheter tricuspid prosthesis, this review discovered an early favorable outcome and a general improvement in heart failure symptoms. However, there was a lot of variation in their design, implantation technique, and early clinical outcomes. Understanding the design variations, difficulty of implantation and learning from this review's key findings could help with the future development of catheter-based tricuspid valves.
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022312142.
三尖瓣反流（TR）的干预往往与二尖瓣手术同时进行并在手术过程中处理。然而，孤立的TR干预并不罕见，且越来越普遍。本研究的目的是综合考虑多种设计变体，对经导管三尖瓣植入（TTVI）装置进行全面概述，并统一TR置换治疗的植入技术、现有临床结果及潜在的未来发展方向。
按照系统评价和Meta分析的首选报告项目（PRISMA）标准，从数据库建立之日至2023年2月10日，对主要数据库，即通过Medline检索的Pubmed、Embase和Cochrane图书馆进行系统检索。
从总共5842篇出版物的队列中筛选出11项研究。所有经导管三尖瓣假体在设计上均为圆形，但分为环三尖瓣植入（ATVI）组和腔静脉瓣植入（CAVI）组。出血（25.2%）、需要干预的严重穿刺部位和血管问题（5.8%）、装置移位或栓塞（3.6%）以及瓣周漏（38%）是已观察到的早期TTVI相关并发症。CAVI组在28例出血病例中有3例，在4例装置移位病例中有2例。
在经导管三尖瓣假体干预后，本综述发现早期预后良好，心力衰竭症状总体有所改善。然而，它们在设计、植入技术和早期临床结果方面存在很大差异。了解设计变体、植入难度并借鉴本综述的关键发现有助于基于导管的三尖瓣瓣膜的未来发展。
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022312142 。
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