Surgery Does Not Improve Survival in Patients With Isolated Severe Tricuspid Regurgitation

Axtell, Andrea L.; Bhambhani, Vijeta; Moonsamy, Philicia; Healy, Emma; Picard, Michael H.; Sundt, Thoralf M.; Wasfy, Jason H.

doi:10.1016/j.jacc.2019.04.028

Cited by 214 publications

(112 citation statements)

References 31 publications

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“…A recent study by Axtell et showed no survival benefit of surgery compared to medical therapy in a large cohort of 3276 patients. No difference was identified between repair and replacement either [63]. However, one of the lessons learned from COAPT and MITRA-FR trials is that a tailored approach could be very successful [19].…”

Section: Transcatheter Tricuspid Valve Therapiesmentioning

confidence: 98%

Advances in transcatheter mitral and tricuspid therapies

Overtchouk

Piazza

Granada

et al. 2020

BMC Cardiovasc Disord

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Background: While rheumatic mitral stenosis has been effectively treated percutaneously for more than 20 years, mitral and tricuspid regurgitation treatment appear as a contemporary unmet need. The advent of transcatheter therapies offer new treatment options to often elderly and frail patients at high risk for open surgery. We aimed at providing an updated review of fast-growing domain of transcatheter mitral and tricuspid technology. Main body: We reviewed the existing literature on mitral and tricuspid transcatheter therapies. Mitraclip is becoming an established therapy for secondary mitral regurgitation in selected patients with disproportionately severe regurgitation associated with moderate left ventricle dysfunction. Evidence is less convincing for primary mitral regurgitation. Transcatheter mitral valve replacement is a promising emerging alternative to transcatheter repair, for secondary as well as primary mitral regurgitation. But further development is needed to improve delivery. Transcatheter tricuspid intervention arrives late after similar technologies have been developed for aortic and mitral valves and is currently at its infancy. This is likely due in part to previously under-recognized impact of tricuspid regurgitation on patient outcomes. Edge-to-edge repair is the most advanced transcatheter solution in development. Data on tricuspid annuloplasty and replacement is limited, and more research is warranted. Conclusion: The future appears bright for transcatheter mitral therapies, albeit their place in clinical practice is yet to be clearly defined. Tricuspid transcatheter therapies might address the unmet need of tricuspid regurgitation treatment.

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Section: Transcatheter Tricuspid Valve Therapiesmentioning

confidence: 98%

Advances in transcatheter mitral and tricuspid therapies

Overtchouk

Piazza

Granada

et al. 2020

BMC Cardiovasc Disord

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“…TV disease is increasingly recognized as an important condition that has an adverse effect on patient survival and quality of life. To date, surgical interventions have not demonstrated improvement in mortality compared to medical therapy, 26 while there is new evidence that percutaneous tricuspid repair is associated with greater survival compared to medical therapy alone 27 . These new transcatheter techniques necessitate high fidelity imaging of the tricuspid valve.…”

Section: Discussionmentioning

confidence: 99%

Three‐dimensional echocardiography for the assessment of the tricuspid valve

2020

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Tricuspid valve pathology is increasingly recognized as an important contributor to patient morbidity. Accordingly, interest in transcatheter interventions for tricuspid valve disease has continued to grow. Echocardiographic imaging of the tricuspid valve has therefore become an integral component of patient assessment and the essential imaging modality for interventional procedures. The need for improved tricuspid valve imaging has highlighted the variability in tricuspid valve anatomy and the difficulties of using two-dimensional (2D) echocardiography alone to determine the location and type of tricuspid valve disease. Here, three-dimensional (3D) imaging using tools such as biplane imaging, multiplanar reconstruction and live 3D acquisition allow a more accurate and efficient evaluation of the tricuspid valve. The 3D imaging of the tricuspid valve is often focused on transesophageal echocardiography, but the more anterior location of the tricuspid valve also lends itself to assessment with transthoracic echocardiography.In this review, we will examine how 3D imaging can complement and enhance the information obtained from 2D echocardiography, and present novel applications for the quantitation of valvular disease and its utility in intraprocedural imaging. K E Y W O R D Scardiac imaging, three-dimensional echocardiography, tricuspid valve

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“…management alone. 27 Hence, a largely unmet clinical need exists for less invasive therapeutic options in these patients.…”

Section: Measurement Of Tadmentioning

confidence: 99%

Role of 3-Dimensional Echocardiography in the Comprehensive Evaluation of the Tricuspid Valve in Patients With Tricuspid Regurgitation

Utsunomiya

Kihara

2020

Circ Rep

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Three-dimensional echocardiography is one of the most promising methods for the diagnosis of valvular heart disease, and recently has become an essential clinical tool owing to the continued development of real-time transesophageal echocardiography (TEE) technology. And now an era of renewed interest and enthusiasm surrounding the diagnosis and treatment of valvular heart disease has come, which is driven by emerging trans-catheter procedures. Nonetheless, little or no attention has been given to the treatment of tricuspid regurgitation (TR). The application of 3D-TEE is useful for simultaneous visualization of all 3 leaflets in order to grasp the whole picture of the tricuspid valve (TV; "en face" view). The implications of 3-D assessment of TV annulus, leaflets, and morphology involve an improved understanding of both the mechanics and treatment of TR. This method has been useful for surgical management, including accurate measurement of tricuspid annular diameter and prediction of the post-surgical outcome. Moreover, this method may be indispensable for detailed and comprehensive evaluation of the TV in patients with TR who are candidates for trans-catheter tricuspid procedures. In addition, color Doppler 3D-TEE has been valuable to identify the location of the regurgitant orifice and the severity of the TR. It is now clear that this method will enhance the diagnosis and management of TR patients.

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Surgery Does Not Improve Survival in Patients With Isolated Severe Tricuspid Regurgitation

Cited by 214 publications

References 31 publications

Advances in transcatheter mitral and tricuspid therapies

Advances in transcatheter mitral and tricuspid therapies

Three‐dimensional echocardiography for the assessment of the tricuspid valve

Role of 3-Dimensional Echocardiography in the Comprehensive Evaluation of the Tricuspid Valve in Patients With Tricuspid Regurgitation

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