1. Transcatheter Tricuspid Valve Intervention in Patients With Previous Left Valve Surgery
- Author
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Mirjam Winkel, Fabien Praz, Matthias Unterhuber, Sebastian Ludwig, Alberto Pozzoli, Hannes Alessandrini, Karl Patrik Kresoja, Giovanni Pedrazzini, Edwin Ho, Michel Zuber, Michael Mehr, Josep Rodés-Cabau, Jörg Hausleiter, Vanessa Moñivas, Guillem Muntané-Carol, Rebecca T. Hahn, Christian Frerker, Jean Michel Juliard, Daniel Braun, Gilbert H.L. Tang, François Philippon, Maurizio Taramasso, John G. Webb, Claudia Harr, Tamim Nazif, Ahmed A. Khattab, Martin B. Leon, Philipp Lurz, Adrian Attinger-Toller, Ulrich Schäfer, Neil Fam, Joachim Schofer, Julia Lurz, Horst Sievert, Ralph Stephan von Bardeleben, Martin Andreas, Ryan Kaple, Mara Gavazzoni, Mizuki Miura, Georg Nickening, Marcel Weber, Susheel Kodali, Daniel Kalbacher, Rodrigo Estevez-Loureiro, Edith Lubos, Azeem Latib, Eric Brochet, Luigi Biasco, Marco Russo, Rishi Puri, Alexander Lauten, Paolo Denti, Marina Urena, Dominique Himbert, Holger Thiele, Kim A. Connelly, Felix Kreidel, and Francesco Maisano
- Subjects
Male ,Cardiac Catheterization ,medicine.medical_specialty ,Ventricular Dysfunction, Right ,Population ,030204 cardiovascular system & hematology ,Patient Readmission ,Risk Assessment ,Severity of Illness Index ,03 medical and health sciences ,0302 clinical medicine ,Risk Factors ,Interquartile range ,Outcome Assessment, Health Care ,medicine ,Humans ,In patient ,Registries ,030212 general & internal medicine ,Cardiac Surgical Procedures ,Left valve ,education ,610 Medicine & health ,Aged ,Heart Valve Prosthesis Implantation ,education.field_of_study ,Tricuspid valve ,Ejection fraction ,business.industry ,EuroSCORE ,Survival Analysis ,Tricuspid Valve Insufficiency ,Surgery ,medicine.anatomical_structure ,Heart Valve Prosthesis ,Cohort ,Female ,Tricuspid Valve ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies - Abstract
BACKGROUND Scarce data exist on patients with previous left valve surgery (PLVS) undergoing transcatheter tricuspid valve intervention (TTVI). This study sought to investigate the procedural and early outcomes in patients with PLVS undergoing TTVI. METHODS This was a subanalysis of the multicenter TriValve registry including 462 patients, 82 (18%) with PLVS. Data were analyzed according to the presence of PLVS in the overall cohort and in a propensity score-matched population including 51 and 115 patients with and without PLVS, respectively. RESULTS Patients with PLVS were younger (72 �� 10 vs 78 �� 9 years; p < 0.01) and more frequently female (67.1% vs 53.2%; P��= 0.02). Similar rates of procedural success (PLVS 80.5%; no-PLVS 82.1%; P��= 0.73), and 30-day mortality (PLVS 2.4%, no-PLVS 3.4%; P��= 0.99) were observed. After matching, there were no significant differences in both all-cause rehospitalisation (PLVS 21.1%, no-PLVS 26.5%; P��= 0.60) and all-cause mortality (PLVS 9.8%, no-PLVS 6.7%; P��= 0.58). At last follow-up (median 6 [interquartile range 1-12] months after the procedure), most patients (81.8%) in the PLVS group were in NYHA functional class I-II (P��= 0.12 vs no-PLVS group), and TR grade was ��� 2 in 82.6% of patients (P��= 0.096 vs no-PVLS group). A poorer right ventricular function and previous heart failure hospitalization determined increased risks of procedural failure and poorer outcomes at follow-up, respectively. CONCLUSIONS In patients with PLVS, TTVI was associated with high rates of procedural success and low early mortality. However, about one-third of patients required rehospitalisation or died at midterm follow-up. These results would support TTVI as a reasonable alternative to redo surgery in patients with PLVS and suggest the importance of earlier treatment to improve clinical outcomes.
- Published
- 2021
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