Schwarting Stéphanie Kristina, Stolz Lukas, Novotny Julia, Massberg Steffen, Näbauer Michael, Hausleiter Jörg
Department of Internal Medicine I (Cardiology), LMU University Hospital, Munich, Germany; Department of Internal Medicine III, Division of Cardiology, University Hospital Heidelberg, Ruprecht-Karl University, Heidelberg, Germany.
Department of Internal Medicine I (Cardiology), LMU University Hospital, Munich, Germany.
JACC Case Rep. 2025 Mar 19;30(6 Pt 2):103414. doi: 10.1016/j.jaccas.2025.103414.
Cardiac transthyretin amyloidosis (ATTR-CM) is an infiltrative, restrictive cardiomyopathy leading to heart failure across all stages of the disease. While specific disease-modulating therapies evolve, interventional therapeutic approaches on atrioventricular valve dysfunction have not yet been investigated in this cardiomyopathy and remain subject to personalized strategy.
We present 2 patients with wild-type ATTR-CM who underwent successful transcatheter tricuspid valve edge-to-edge repair (T-TEER) for severe tricuspid regurgitation (TR) 2-4 years after initial diagnosis. T-TEER was successful, and patients presented with a considerable improvement of their functional status.
T-TEER represents an important therapeutic strategy for patients with TR and ATTR-CM, in whom treatment options for symptomatic improvement are scarce.
TAKE-HOME MESSAGES: T-TEER might be considered in patients with TR and restrictive cardiomyopathy, such as ATTR-CM in its advanced stages. Short-term outcomes demonstrate a considerable improvement of functional capacity on top of optimal medical therapy for ATTR-CM.
心脏转甲状腺素蛋白淀粉样变性心肌病（ATTR-CM）是一种浸润性、限制性心肌病，可在疾病的各个阶段导致心力衰竭。虽然特异性疾病调节疗法不断发展，但针对这种心肌病的房室瓣功能障碍的介入性治疗方法尚未得到研究，仍需个性化策略。
我们报告2例野生型ATTR-CM患者，在初次诊断后2 - 4年因严重三尖瓣反流（TR）接受了成功的经导管三尖瓣缘对缘修复术（T-TEER）。T-TEER手术成功，患者的功能状态有显著改善。
T-TEER是TR和ATTR-CM患者的一种重要治疗策略，这类患者改善症状的治疗选择较少。
对于TR和限制性心肌病患者，如晚期ATTR-CM患者，可考虑T-TEER。短期结果表明，在ATTR-CM的最佳药物治疗基础上，功能能力有显著改善。
