Transcatheter Tricuspid Valve Replacement: Illustrative Case Reports and Review of State-of-Art
Abstract
:1. Introduction
2. Cardiovalve Cases
3. Lux-Valve Plus Case
4. Ttvr Portfolio Review
4.1. Navigate
4.2. Cardiovalve
4.3. Evoque
4.4. LuX-Valve
4.5. Early Experience Phase with Other Devices
5. Ttvr Clinical Results Review
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
TR | tricuspid regurgitation |
TV | tricuspid valve |
TTVR | transcatheter tricuspid valve replacement |
CT | computed tomography |
TEE | transoesophageal echocardiography |
TTE | transthoracic echocardiography |
References
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Device Name (Manufacturer) | Design | Access | Delivery Sheath Size | Anchoring Mechanism | Pacemaker Implant | Procedural Success in Trials | Conversion to Open Heart Surgery | Reduction of TR to Mild or Less |
---|---|---|---|---|---|---|---|---|
Gate (NaviGate Cardiac Structures, Inc.) | nitinol self-expanding conical stent with a tri-leaflet equine pericardial valve | Transjugular or transatrial | 42 Fr | Native leaflets grasping | N/A | 87% | 5% | 76% |
Cardiovalve (Cardiovalve, Lda) | self-expanding nitinol frame with 3 bovine pericardial leaflets | transfemoral | 28 Fr | Native leaflets grasping | N/A | N/A | N/A | N/A |
Evoque TV (Edwards Lifesciences) | self-expanding nitinol frame, bovine pericardial leaflets, and an intra-annular sealing skirt | transfemoral | 28 Fr | Annulus, leaflets and chords | 13% | 94% | 1% | 99% |
LuX-Valve (Jenscare Biotechnology) | self-expanding stented valve, composed by a tri-leaflet bovine pericardium valve, with an external nitinol stent covered with a layer of polyethylene terephthalate | Transapical or transjugular | 33 Fr | Anterior leaflet grasping and septal anchor | 0% | 100% | 0% | 83% |
Navigate | Evoque | LuX-Valve | LuX-Valve Plus | ||
---|---|---|---|---|---|
Hahn et al. | Fam et al. | Kodali et al. | Mao et al. | Zhang et al. | |
Baseline characteristics | |||||
Number of patients | 30 | 25 | 56 | 15 | 10 |
Age, years (IQR) | 78 (70–80) | 76 (73–79) | 79.3 | 62 (56–78) | 70 |
NYHA III or IV, nº (%) | 85.7% | 88.0% | 87.5% | 15 (100) | 10 (100) |
TR severity | |||||
Moderate | 2 (6.6) | 4 (16.0) | 8.9% | 0 (0.0) | 0 (0.0) |
≥Severe | 28 (92.4) | 25 (100) | 91.1% | 15 (100) | 10 (100) |
Procedure | |||||
Procedural success, nº (%) | 26 (87.0) | 23 (92.0) | NA | 15 (100) | 10 (100) |
Conversion to open surgery, nº (%) | 2 (6.6) | 0 | 1 (1.8) | 0 (0.0) | 0 (0.0) |
Device embolization or malposition, nº (%) | 4 (13.3) | 1 (4.0) | 2 (3.6) | 0 (0.0) | 0 (0.0) |
30-day outcomes | |||||
Mortality | 3 (10) | 0 (0.0) | 1 (1.8) | 1 (6.6) | 0 (0.0) |
Stroke | 1 (3.3) | 0 (0.0) | 0 (0) | 0 (0.0) | 0 (0.0) |
Major or life-threatening bleeding | 10 (30) | 3 (12.0) | 1 (1.8) | 1 (8) | 0 (0.0) |
Others | 1 death for uncontrolled bleeding, 1 multiorgan failure, 1 after surgical conversion | 2 pacemaker implantations | 1 cardiovascular death, 2 reinterventions, 1 major access site or vascular complication | 1 death related to pulmonary infection | 1 pacemaker implantation for a complete AV block |
TR post-procedural | |||||
Mild or less | 67.0% | 88.0% | 98.1% | 85.7% | 10 (100) |
Moderate | 14.0% | 8.0% | 1.9% | 7.1% | 0 (0.0) |
≥Severe | 19.0% | 4.0% | 0 (0.0) | NA | 0 (0.0) |
1 year outcomes | Webb et al. | ||||
Mortality (30d-1 year) | 7.4% | 0 (0.0) | |||
Stroke | 0 (0.0) | ||||
Major or life-threatening bleeding | 0 (0.0) | ||||
NYHA I or II, nº (%) | 70.0% | 76.8% | |||
Others | 2 HF hospitalizations, 1 patient new pacemaker implantation | 1 device thrombosis | |||
TR 1 year | |||||
Mild or less | 87.0% | 85.7% | |||
Moderate | 9.0% | NA | |||
≥Severe | 4.0% | NA |
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Barreiro-Pérez, M.; González-Ferreiro, R.; Caneiro-Queija, B.; Tavares-Silva, M.; Puga, L.; Parada-Barcia, J.A.; Rodriguez-Perez, A.; Baz-Alonso, J.A.; Pinon-Esteban, M.A.; Estevez-Loureiro, R.; et al. Transcatheter Tricuspid Valve Replacement: Illustrative Case Reports and Review of State-of-Art. J. Clin. Med. 2023, 12, 1371. https://doi.org/10.3390/jcm12041371
Barreiro-Pérez M, González-Ferreiro R, Caneiro-Queija B, Tavares-Silva M, Puga L, Parada-Barcia JA, Rodriguez-Perez A, Baz-Alonso JA, Pinon-Esteban MA, Estevez-Loureiro R, et al. Transcatheter Tricuspid Valve Replacement: Illustrative Case Reports and Review of State-of-Art. Journal of Clinical Medicine. 2023; 12(4):1371. https://doi.org/10.3390/jcm12041371
Chicago/Turabian StyleBarreiro-Pérez, Manuel, Rocío González-Ferreiro, Berenice Caneiro-Queija, Marta Tavares-Silva, Luis Puga, Jose A Parada-Barcia, Alvaro Rodriguez-Perez, Jose A Baz-Alonso, Miguel A Pinon-Esteban, Rodrigo Estevez-Loureiro, and et al. 2023. "Transcatheter Tricuspid Valve Replacement: Illustrative Case Reports and Review of State-of-Art" Journal of Clinical Medicine 12, no. 4: 1371. https://doi.org/10.3390/jcm12041371