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使用LuX-Valve Plus系统逐步进行经导管三尖瓣置换术。

Step-by-Step Transcatheter Tricuspid Valve Replacement Using the LuX-Valve Plus System.

作者信息

Wong Ling-Na, Kam Kevin Ka-Ho, Lai Leo Kar-Lok, Chow Simon Chi-Ying, Lam Yat-Yin, Wan Song, Lee Alex Pui-Wai, So Kent Chak-Yu

机构信息

Division of Cardiology, Department of Medicine and Therapeutics, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.

Division of Cardiothoracic Surgery, Department of Surgery, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China.

出版信息

JACC Case Rep. 2024 Nov 6;29(21):102699. doi: 10.1016/j.jaccas.2024.102699.

DOI:10.1016/j.jaccas.2024.102699
PMID:39619032
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11602624/
Abstract

The LuX-Valve Plus is a novel radial force-independent orthotopic transjugular transcatheter tricuspid valve replacement device proven to be effective in TR reduction. We describe preprocedural assessment for eligibility and procedural planning by means of computed tomography as well as procedural steps of device implantation under multimodality imaging guidance including transesophageal echocardiography (TEE), intracardiac echocardiography (ICE), and fluoroscopy: steering into the right ventricle, leaflet capture by graspers, fine valve adjustment, and septal anchor deployment. Potential pitfalls are avoided by achieving optimal alignment by means of TEE multiplanar reconstruction to steer the delivery system, and using mid-esophageal and deep gastric views of 3-dimensional TEE and supplementary ICE to visualize the graspers for leaflet capture, especially when TEE imaging is technically challenging. In the presence of paravalvular leak after valve deployment, use fine adjustment functions to optimize the result before final release.

摘要

LuX-Valve Plus是一种新型的与径向力无关的原位经颈静脉经导管三尖瓣置换装置，已被证明在减少三尖瓣反流方面有效。我们描述了通过计算机断层扫描进行的术前资格评估和程序规划，以及在多模态成像引导下（包括经食管超声心动图（TEE）、心内超声心动图（ICE）和荧光透视）进行装置植入的程序步骤：进入右心室、用抓钳捕获瓣叶、精细瓣膜调整和部署间隔锚定。通过利用TEE多平面重建实现最佳对齐以引导输送系统，并使用三维TEE的食管中段和深部胃视图以及辅助ICE来可视化抓钳以捕获瓣叶，避免潜在陷阱，尤其是在TEE成像技术上具有挑战性时。瓣膜部署后出现瓣周漏时，在最终释放前使用精细调整功能优化结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ae/11602624/efcbfcc30745/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ae/11602624/9da719d36c46/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ae/11602624/2ff2b1ff7f4c/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ae/11602624/5372cc4864b2/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ae/11602624/dcb582c9da51/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ae/11602624/ff0caff14df2/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ae/11602624/efcbfcc30745/gr5.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ae/11602624/9da719d36c46/ga1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ae/11602624/2ff2b1ff7f4c/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ae/11602624/5372cc4864b2/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ae/11602624/dcb582c9da51/gr3.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ae/11602624/ff0caff14df2/gr4.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/84ae/11602624/efcbfcc30745/gr5.jpg

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Circ Rep. 2025 Mar 13;7(5):393-394. doi: 10.1253/circrep.CR-25-0020. eCollection 2025 May 9.

本文引用的文献

1
A first-in-human study of transjugular transcatheter tricuspid valve replacement with the LuX-Valve Plus system.一项使用LuX-Valve Plus系统经颈静脉进行经导管三尖瓣置换的人体首例研究。
EuroIntervention. 2023 Feb 6;18(13):e1088-e1089. doi: 10.4244/EIJ-D-22-00517.