Tricuspid Valve Academic Research Consortium Definitions for Tricuspid Regurgitation and Trial Endpoints

Hahn, Rebecca T.; Lawlor, Matthew K.; Davidson, Charles J.; Badhwar, Vinay; Sannino, Anna; Spitzer, Ernest; Lurz, Philipp; Lindman, Brian R.; Topilsky, Yan; Baron, Suzanne J.; Chadderdon, Scott; Khalique, Omar K.; Tang, Gilbert H.L.; Taramasso, Maurizio; Grayburn, Paul A.; Badano, Luigi; Leipsic, Jonathon; Lindenfeld, JoAnn; Windecker, Stephan; Vemulapalli, Sreekanth; Redfors, Bjorn; Alu, Maria C.; Cohen, David J.; Rodés-Cabau, Josep; Ailawadi, Gorav; Mack, Michael; Ben-Yehuda, Ori; Leon, Martin B.; Hausleiter, Jörg; Arnold, Suzanne; Bapat, Vinayak; Berry, Natalia; Blanke, Philipp; Burkhoff, Daniel; Coylewright, Megan; Duggal, Neal; Galper, Benjamin; George, Isaac; Guerrero, Mayra; Hamid, Nadira; Jagadeesan, Vikrant; Kodali, Susheel; Krucoff, Mitch; Lang, Roberto; Madhavan, Mahesh; McLaughin, Vallerie; Mehran, Roxana; Philippon, Francois; Sethi, Sanjum S.; Simonato, Matheus; Smith, Robert; Sodhi, Nishtha; Spertus, John; Stocker, Thomas J.; Stone, Gregg

doi:10.1016/j.athoracsur.2023.09.018

Cited by 6 publications

(2 citation statements)

References 102 publications

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“…Patients enrolled for surgery are managed with a minimally invasive protocol consisting of a right mini-thoracotomy approach, a full peripheral cannulation, and tailored perfusion strategies and aortic clamping techniques; when possible, TV surgery is performed on a beating heart. The minimally invasive approach allows shorter ventilation times, shorter ICU length of stay, early removal of drains, early mobilization, and faster return to home, which is particularly important in such fragile patients [ 11 ].…”

Section: Methodsmentioning

confidence: 99%

Surgical Treatment for Isolated Tricuspid Valve Disease: A Less Invasive Approach for Better Outcomes

Barbero,

Pocar,

Brenna

et al. 2024

JCM

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Background. Severe tricuspid valve (TV) disease has a strong association with right ventricle dysfunction, heart failure and mortality. Nevertheless, surgical indications for isolated TV disease are still uncommon. The purpose of this study is to analyze outcomes of patients undergoing minimally invasive isolated TV surgery (ITVS). Methods. Data of patients undergoing right mini-thoracotomy ITVS were prospectively collected. A subgroup analysis was performed on late referral patients. Five-year survival was assessed using the Kaplan–Meier survival estimate. Results. Eighty-one consecutive patients were enrolled; late referral was recorded in 8 out of 81 (9.9%). No cases of major vascular complications nor of stroke were reported. A 30-day mortality was reported in one patient (1.2%). Five-year Kaplan–Meier survival analysis revealed a significant difference between late referral patients and the control group (p = 0.01); late referral and Euroscore II were found to be significantly associated with reduced mid-term survival (p = 0.005 and p = 0.01, respectively). Conclusions. To date, perioperative mortality in patients undergoing ITVS is still consistently high, even in high-volume, high-experienced centres, and this accounts for the low rate of referral. Results from our report show that, with proper multidisciplinary management, appropriate pre-operative screening, and allocation to the safest approach, ITVS may offer better results than expected.

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Section: Methodsmentioning

confidence: 99%

Surgical Treatment for Isolated Tricuspid Valve Disease: A Less Invasive Approach for Better Outcomes

Barbero,

Pocar,

Brenna

et al. 2024

JCM

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“…1,2 As TR progresses, right ventricular (RV) dysfunction develops due to volume overload on the right ventricle, further exacerbating the prognosis of according to the current consensus. 17 Cardiac chamber quantification and evaluation of systolic function were performed according to international guidelines. 18 RV fractional area change (RVFAC) was measured at the RV-focused apical four-chamber view as follows: RVFAC (%) = 100 × (RV end-diastolic area -RV end-systolic area)/RV end-diastolic area.…”

Section: Introductionmentioning

confidence: 99%

Changes in right ventricular function and clinical outcomes following tricuspid transcatheter edge‐to‐edge repair

Tanaka,

Sugiura,

Kavsur

et al. 2024

European J of Heart Fail

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AimsPrognostic impact of post‐procedural changes in right ventricular (RV) function after tricuspid transcatheter edge‐to‐edge repair (T‐TEER) is still unclear. We investigated association of RV function and its post‐procedural changes with clinical outcomes in patients undergoing T‐TEER.Methods and resultsWe retrospectively analysed 204 patients who underwent T‐TEER and echocardiographic follow‐up at 3 months after T‐TEER. RV function was assessed by RV fractional area change (RVFAC), and RV dysfunction was defined as RVFAC <35%. Patients with an increase in RVFAC from baseline to the follow‐up were considered as RV responders. Patients were divided into four groups according to baseline RVFAC and the RV responder. The primary outcome was a composite of mortality and hospitalization due to heart failure within 1 year. Forty‐five of 204 patients (22.1%) had RVFAC <35% at baseline, and 71 (34.8%) were RV responders. The association between the RV responder and the composite outcome had a significant interaction with RVFAC at baseline. Among patients with baseline RVFAC <35%, RV responders had a lower risk of the composite outcome than RV non‐responders, while this association was not significant in those with baseline RVFAC ≥35%. Among patients with baseline RVFAC <35%, a smaller RV diameter and a greater reduction of tricuspid regurgitation were predictors for the RV responder.ConclusionPost‐procedural increase in RVFAC after T‐TEER is associated with improved outcomes in patients with RV dysfunction. The factors related to the increase in RVFAC may support patient selection for T‐TEER in patients with RV dysfunction.

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Outcomes of Isolated Tricuspid Valve Surgery: A Society of Thoracic Surgeons Analysis and Risk Model

Thourani,

Bonnell,

Wyler von Ballmoos

et al. 2024

The Annals of Thoracic Surgery

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Tricuspid Valve Academic Research Consortium Definitions for Tricuspid Regurgitation and Trial Endpoints

Cited by 6 publications

References 102 publications

Surgical Treatment for Isolated Tricuspid Valve Disease: A Less Invasive Approach for Better Outcomes

Surgical Treatment for Isolated Tricuspid Valve Disease: A Less Invasive Approach for Better Outcomes

Changes in right ventricular function and clinical outcomes following tricuspid transcatheter edge‐to‐edge repair

Outcomes of Isolated Tricuspid Valve Surgery: A Society of Thoracic Surgeons Analysis and Risk Model

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