Sun Yandan, Cao Liang, Bai Wei, Li Yuxi, Yang Jian, Jiang Guomeng, Liu Yang, Jin Ping, Liu Liwen, Meng Xin
Department of Ultrasound Medicine, the First Affiliated Hospital of the Air Force Medical University (Xijing Hospital), Xi'an 710032, China.
Department of Ultrasonography, the 986th Hospital of the Air Force Medical University, Xi'an 710054, China.
Zhejiang Da Xue Xue Bao Yi Xue Ban. 2025 Mar 25;54(2):213-218. doi: 10.3724/zdxbyxb-2024-0365.
To compare the efficacy of transcatheter tricuspid valve replacement (TTVR) using Lux-Valve and Lux-Valve Plus in patients with severe tricuspid regurgitation.
A total of 28 consecutive patients with severe tricuspid regurgitation who underwent TTVR with Lux-Valve (=14) or Lux-Valve Plus (=14) in the First Affiliated Hospital of the Air Force Medical University from August 2019 to November 2023 were enrolled. Transthoracic echocardiography was performed in all patients before and 6 months after the TTVR. The ultrasound indexes were compared before and 6 months after the TTVR in all patients and between Lux-Valve and Lux-Valve Plus groups.
Compared with the Lux-Valve group, the Lux-Valve Plus group showed significantly reduced intraoperative bleeding and shorter postoperative hospital stays (both <0.05). Six months after the TTVR, none of the patients exhibited more than a mild tricuspid valve regurgitation, and none of the patients had moderate or above perivalvular leakage except for one patient in the Lux-Valve Plus group who had a separation of the clamping member from the anterior tricuspid leaflet. The incidence of perivalvular leakage was significantly lower in the Lux-Valve Plus group (14.29%, 2/14) than in the Lux-Valve group (64.29%, 9/14, <0.05). At 6 months after operation, the right chamber volume and right ventricle middle transverse diameter were reduced (both <0.05); the peak blood flow velocity across the tricuspid valve, peak pressure gradient across the tricuspid valve, mean blood flow velocity of tricuspid valve, mean pressure gradient across the tricuspid valve and velocity time integral were increased in both groups (all <0.05).Compared with the Lux-Valve group, the Lux-Valve Plus group showed higher left ventricular ejection fraction at 6 months postoperatively (<0.05), while the rest of the indicators were not statistically different (all >0.05).
The efficacy of using Lux-Valve and Lux-Valve Plus for TTVR in patients with severe tricuspid regurgitation is comparable. Six months after the TTVR, the right side of the heart has undergone reverse remodeling.While Lux-Valve Plus offers greater minimally invasive benefits, valve selection should consider device-specific characteristics and differences in individual patients.
比较使用Lux-Valve和Lux-Valve Plus经导管三尖瓣置换术（TTVR）治疗严重三尖瓣反流患者的疗效。
纳入2019年8月至2023年11月在空军军医大学第一附属医院连续接受Lux-Valve（n = 14）或Lux-Valve Plus（n = 14）TTVR治疗的28例严重三尖瓣反流患者。所有患者在TTVR术前和术后6个月进行经胸超声心动图检查。比较所有患者TTVR术前和术后6个月以及Lux-Valve组和Lux-Valve Plus组之间的超声指标。
与Lux-Valve组相比，Lux-Valve Plus组术中出血明显减少，术后住院时间缩短（均P<0.05）。TTVR术后6个月，所有患者均未出现超过轻度的三尖瓣反流，除Lux-Valve Plus组1例患者出现夹持部件与三尖瓣前叶分离外（该患者有中度或以上瓣周漏），其余患者均无中度或以上瓣周漏。Lux-Valve Plus组瓣周漏发生率（14.29%，2/14）明显低于Lux-Valve组（64.29%，9/14，P<0.05）。术后6个月，右心房容积和右心室中部横径减小（均P<0.05）；两组三尖瓣跨瓣血流峰值速度、三尖瓣跨瓣峰值压力阶差、三尖瓣平均血流速度、三尖瓣平均压力阶差和速度时间积分均增加（均P<0.05）。与Lux-Valve组相比，Lux-Valve Plus组术后6个月左心室射血分数更高（P<0.05），而其余指标差异无统计学意义（均P>0.05）。
使用Lux-Valve和Lux-Valve Plus进行TTVR治疗严重三尖瓣反流患者的疗效相当。TTVR术后6个月，心脏右侧发生逆向重塑。虽然Lux-Valve Plus具有更大的微创优势，但瓣膜选择应考虑器械的特定特征和个体患者差异。
