Tricuspid Annuloplasty: Transcatheter Approaches

Arnold, Martin; Haug, Julia; Landendinger, Melanie

doi:10.1007/s11886-021-01570-8

Cited by 4 publications

(4 citation statements)

References 22 publications

(19 reference statements)

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“…Surgical techniques are extremely effective in reducing or eliminating TR. [ 5 ] Preferably, annuloplasty techniques either suture based or involving annuloplasty rings should be used for the treatment of FTR instead of valve replacement. [ 5 ] Furthermore, relatively high mortality rates (8.8%–9.7%) have been reported after conventional surgery for isolated TR.…”

Section: Discussionmentioning

confidence: 99%

“…[ 5 ] Preferably, annuloplasty techniques either suture based or involving annuloplasty rings should be used for the treatment of FTR instead of valve replacement. [ 5 ] Furthermore, relatively high mortality rates (8.8%–9.7%) have been reported after conventional surgery for isolated TR. [ 6 ] In order to address this problem, several catheter-based techniques that mimic the surgical annuloplasty techniques have been developed.…”

Section: Discussionmentioning

confidence: 99%

“…[ 6 ] In order to address this problem, several catheter-based techniques that mimic the surgical annuloplasty techniques have been developed. [ 5 ] The concept of K-clip™ is different from existing TTVI. K-clip™ uses a transjugular access.…”

Section: Discussionmentioning

confidence: 99%

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K-clip™, a Novel Transcatheter Treatment in Patients with Severely Tricuspid Regurgitation

Ding,

Xu,

Zhang

et al. 2024

Heart Views

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Patients who suffer from severe tricuspid regurgitation (TR) and who are at high surgical risk have no standard care therapy. Therefore, minimally invasive and safer methods are sought. K-clip™, the first ultrasound-positioned interventional tricuspid annuloplasty instrument intended for percutaneous transcatheter repair. We report a patient with severe functional TR and high surgical risk who underwent K-clip™ tricuspid annuloplasty under echocardiography and fluoroscopy guidance.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

K-clip™, a Novel Transcatheter Treatment in Patients with Severely Tricuspid Regurgitation

Ding,

Xu,

Zhang

et al. 2024

Heart Views

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“…Recently published reports on RCA deformation after interventional tricuspid annuloplasty revealed that RCA deformations without flow limitation recover after a few days ( 6 ). Thus, the unreported rate of RCA deformations without flow limitation might be even higher, as it seems not to be clinically harmful ( 12 ). Yet, long-term data were still lacking.…”

Section: Discussionmentioning

confidence: 99%

Right coronary artery deformation and injury following tricuspid valve surgery

Gerçek

Omran²,

Friedrichs³

et al. 2022

Front. Cardiovasc. Med.

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BackgroundDue to its close anatomical proximity to the annular plane of the tricuspid valve (TV), the right coronary artery (RCA) is at risk of injury and distortion during surgical and interventional repair. Recently, reversible, non-flow limiting, purse-string like deformations of the RCA following percutaneous TV annuloplasty have been described. In contrast, there are only anecdotal reports on RCA deformation following conventional TV surgery.Materials and methodsA retrospective analysis of all patients undergoing TV surgery in our hospital between 2009 and 2019 was performed including all patients who received a post-operative coronary angiography (POCA). Angiographic footage was reviewed for RCA affections.ResultsA total of 1,383 patients underwent TV surgery (replacement and repair) for tricuspid regurgitation in our center. TV repair was performed in 1,248 (90.2%) patients and 135 (9.8%) patients underwent isolated TV surgery. Sixty-five patients (4.7%) underwent POCA within 48 h after surgery due to suspected myocardial ischemia, representing the final study population. Mean age was 70.3 ± 11.3 years, 56.3% were female. Mean EuroSCORE II was 9.8 ± 11.6%. Patients with the need for POCA due to suspected myocardial injury suffered from a higher mortality compared to event-free patients over the long-term follow up period (median 2.9 years) regardless of the observed coronary status. RCA affections were observed in 24 (36.9%) patients. A new RCA deformation without flow-impairment or vascular damage was found in 16 (24.6%) of the cases and was managed conservatively. There was no significantly worse outcome observed as compared to patients without RCA affections. Six (9.2%) patients showed an RCA deformation accompanied by subtotal occlusion. A complete RCA-occlusion was observed in 2 (3.1%) patients. Revascularization by percutaneous coronary intervention could be successfully performed in these patients. RCA deformation occurred exclusively after TV repair while no cases were observed after TV replacement.ConclusionRight coronary artery deformation without flow-limitation following surgical TV repair is a specific/typical phenomenon which might not impair patients’ outcome and could be managed conservatively in most of the cases. RCA injury indicating further interventional therapy is a rare complication of TV surgery. However, the need for immediate POCA in general appears to be associated with a worsened intermediate-term outcome.

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A multifunctional soft robot for cardiac interventions

Rogatinsky,

Recco,

Feichtmeier

et al. 2023

Sci. Adv.

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In minimally invasive endovascular procedures, surgeons rely on catheters with low dexterity and high aspect ratios to reach an anatomical target. However, the environment inside the beating heart presents a combination of challenges unique to few anatomic locations, making it difficult for interventional tools to maneuver dexterously and apply substantial forces on an intracardiac target. We demonstrate a millimeter-scale soft robotic platform that can deploy and self-stabilize at the entrance to the heart, and guide existing interventional tools toward a target site. In two exemplar intracardiac procedures within the right atrium, the robotic platform provides enough dexterity to reach multiple anatomical targets, enough stability to maintain constant contact on motile targets, and enough mechanical leverage to generate newton-level forces. Because the device addresses ongoing challenges in minimally invasive intracardiac intervention, it may enable the further development of catheter-based interventions.

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Tricuspid Annuloplasty: Transcatheter Approaches

Cited by 4 publications

References 22 publications

K-clip™, a Novel Transcatheter Treatment in Patients with Severely Tricuspid Regurgitation

K-clip™, a Novel Transcatheter Treatment in Patients with Severely Tricuspid Regurgitation

Right coronary artery deformation and injury following tricuspid valve surgery

A multifunctional soft robot for cardiac interventions

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