Outcomes of TTVI in Patients With Pacemaker or Defibrillator Leads

Taramasso, Maurizio; Gavazzoni, Mara; Pozzoli, Alberto; Alessandrini, Hannes; Latib, Azeem; Attinger‐Toller, Adrian; Biasco, Luigi; Braun, Daniel; Brochet, Éric; Connelly, Kim A.; Bruijn, Sabine de; Denti, Paolo; Deuschl, Florian; Estevez-Louriero, Rodrigo; Fam, Neil; Frerker, Christian; Ho, Edwin; Juliard, Jean Michel; Kaple, Ryan; Kodali, Susheel; Kreidel, Felix; Kuck, Karl Heinz; Lauten, Alexander; Lurz, Julia; Moñivas, Vanessa; Mehr, Michael; Nazif, Tamin; Nickening, Georg; Pedrazzini, Giovanni; Praz, Fabien; Puri, Rishi; Rodés‐Cabau, Josep; Schäfer, Ulrich; Schöfer, Joachim; Sievert, Horst; Tang, Gilbert H.L.; Khattab, Ahmed A.; Thiele, Holger; Unterhuber, Matthias; Vahanian, Alec; Bardeleben, Ralph Stephan von; Webb, John G.; Weber, Marcel; Windecker, Stephan; Winkel, Mirjam; Züber, Michel; Hausleiter, Jörg; Lurz, Philipp; Maisano, Francesco; Leon, Martin B.; Hahn, Rebecca T.

doi:10.1016/j.jcin.2019.10.058

Cited by 40 publications

(32 citation statements)

References 32 publications

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“…The main jet location in the TriValve registry was in the favorable central/anteroseptal location in CIED patients, which is contrary to our CIED patients [30].…”

Section: Discussioncontrasting

confidence: 95%

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The impact of tricuspid annular geometry on outcome after percutaneous edge-to-edge repair for severe tricuspid regurgitation

et al. 2021

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Background: Percutaneous tricuspid repair using the edge-to-edge technique is a novel treatment option. More data are needed to better understand which aspects predict a favorable outcome Methods: Twenty high-risk patients (78.6 ± 8.3 years, EUROScore II 9.1 ± 7.7%, STS score 8.8 ± 4.3) with severe symptomatic tricuspid regurgitation (TR) were treated with the MitraClip ® system. All patients underwent standardized pre-, peri-, and post-procedural evaluation. Acute success was defined as successful edge-to-edge repair with TR reduction of ≥ 1 grade and survival until hospital discharge.Results: Fifteen (75%) patients showed acute success until discharge and 12 (60%) at 30-day follow-up. In 5 (25%) patients repair failed due to either unsuccessful clip implantation (n = 2), single leaflet device attachment (n = 1), TR reduction < 1 grade (n = 1), or in-hospital death (n = 1). Comparing patients with successful procedure versus those with failed repair revealed similar comorbidities but more severe right heart failure, lower left ventricular ejection fraction, worse renal function, and higher diuretic equivalent doses in the failed repair group. No differences in conventional echocardiographic parameters for TR severity but more dilated tricuspid annulus geometry (tricuspid valve [TV] annulus, coaptation depth, tenting area) in the failed repair group were observed. The success rate of non-central/nonanteroseptal jet location was only 25%. Conclusions:Tricuspid annulus geometry assessment may be of crucial importance and seems to impact procedural outcomes in patients undergoing edge-to-edge TV repair. Further investigations including advanced imaging are needed to better understand and treat this complex valve disease.

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“…The main jet location in the TriValve registry was in the favorable central/anteroseptal location in CIED patients, which is contrary to our CIED patients [30].…”

Section: Discussioncontrasting

confidence: 95%

“…Only 3 of our patients (15%) had a CIED, compared to 26% in the TriValve registry. However, all 3 CIED patients failed TTVI at 30-day followup, which is contrary to the reported success rate of 78.6% in the TriValve cohort [30]. This difference in outcome might be related to our sample size or possibly due to patient selection.…”

Section: Discussioncontrasting

confidence: 70%

The impact of tricuspid annular geometry on outcome after percutaneous edge-to-edge repair for severe tricuspid regurgitation

et al. 2021

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“…In cases of CIED-lead induced TR, decision should be made individually according to the above mentioned anatomic findings. Data from the TriValve registry showed comparable procedural success and clinical endpoints compared to patients without CIED lead (98).…”

Section: Patient Selectionmentioning

confidence: 94%

Imaging and Patient Selection for Transcatheter Tricuspid Valve Interventions

Winkel

Brugger

Khalique

et al. 2020

Front. Cardiovasc. Med.

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With the emergence of transcatheter solutions for the treatment of tricuspid regurgitation (TR) increased attention has been directed to the once neglected tricuspid valve (TV) complex. Recent studies have highlighted new aspects of valve anatomy and TR etiology. The assessment of valve morphology along with quantification of regurgitation severity and RV function pose several challenges to cardiac imagers guiding transcatheter valve procedures. This review article aims to give an overview over the role of modern imaging modalities during assessment and treatment of the TV.

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“…Moreover, the presence of a lead poses specific technical challenges in terms of procedural imaging and device positioning. Updated findings from the TriValve registry on 470 patients comparing CIED (26%) against non-CIED patients (74%) found comparable feasibility, acute procedural success, safety, and short-term outcomes between the two groups (43). Thus, the presence of a pacemaker lead through the TV should not preclude a transcatheter option to fix TR.…”

Section: The Good Devicementioning

confidence: 99%

New Percutaneous Options for Tricuspid Intervention: How to Identify the Good Clinical Candidate

Laricchia

Khokhar

Giannini

2020

Front. Cardiovasc. Med.

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The tricuspid valve has been neglected for a long time and severe tricuspid regurgitation (TR) was largely undertreated in the past due to a high operative risk. In the last years we observed the development of different less invasive percutaneous options to treat TR. Currently, percutaneous treatments are reserved for high-risk patients presenting with advanced stage disease by which time they are likely to derive a partial benefit at best. There is a limited evidence base, including no randomized trials, to guide the management strategy for severe TR. In the interim we feel that choosing the best device for the most appropriate clinical candidate and with an adequate timing (most probably an “earlier” timing) will be the key combination to improve early and late outcomes of percutaneous treatments.

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Outcomes of TTVI in Patients With Pacemaker or Defibrillator Leads

Cited by 40 publications

References 32 publications

The impact of tricuspid annular geometry on outcome after percutaneous edge-to-edge repair for severe tricuspid regurgitation

The impact of tricuspid annular geometry on outcome after percutaneous edge-to-edge repair for severe tricuspid regurgitation

Imaging and Patient Selection for Transcatheter Tricuspid Valve Interventions

New Percutaneous Options for Tricuspid Intervention: How to Identify the Good Clinical Candidate

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