Early Clinical Experience With the TRICENTO Bicaval Valved Stent for Treatment of Symptomatic Severe Tricuspid Regurgitation: A Multicenter Registry.

Wild, Mirjam G; Lubos, Edith; Cruz-Gonzalez, Ignacio; Amat-Santos, Ignacio; Ancona, Marco; Andreas, Martin; Boeder, Niklas F; Butter, Christian; Carrasco-Chinchilla, Fernando; Estevez-Loureiro, Rodrigo; Kempfert, Jörg; Köll, Benedikt; Montorfano, Matteo; Nef, Holger M; Toggweiler, Stefan; Unbehaun, Axel; Werner, Paul; Windecker, Stephan; Praz, Fabien (2022). Early Clinical Experience With the TRICENTO Bicaval Valved Stent for Treatment of Symptomatic Severe Tricuspid Regurgitation: A Multicenter Registry. Circulation. Cardiovascular interventions, 15(3), e011302. American Heart Association 10.1161/CIRCINTERVENTIONS.121.011302

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BACKGROUND

Patients with severe tricuspid regurgitation present late and are often ineligible for surgery or transcatheter repair systems. Transfemoral venous implantation of a bicaval valved stent has been proposed as therapeutic option in selected patients. The aim of this study was to summarize the early procedural and clinical outcomes of the novel TRICENTO system for the treatment of patients with symptomatic severe tricuspid regurgitation.

METHODS

All consecutive patients treated with the custom-made TRICENTO implant at the participating centers were included in this retrospective multicentre registry.

RESULTS

A total of 21 high-risk patients (mean age 76±7 years; 67% female) with severe or higher grade tricuspid regurgitation were analyzed. The majority of the patients were in New York Heart Association class III/IV (95%), had peripheral edema (95%), and previous hospitalization for right heart failure (67%). Technical success was 100%, and there was no case of in-hospital mortality. During follow-up (median 61 days), symptomatic improvement was observed (65% in New York Heart Association class I/II; P<0.001). Computed tomography revealed asymptomatic fractures of the TRICENTO prosthesis in 3 patients. Cardiac magnetic resonance imaging obtained in 7 patients showed a significant decrease (252±65 mm3 at baseline versus 216±58 mm3 at follow-up, P=0.006) of right ventricular end-diastolic volume. The overall-survival rate was 76% at 1 year.

CONCLUSIONS

The present data indicate the feasibility of transfemoral bicaval valved stent implantation for the treatment of severe tricuspid regurgitation. Functional improvement and signs of right ventricular reverse remodeling were observed. Stent fractures did not impair valve function, but require refinement of prosthesis design and careful assessment of eligibility criteria.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Wild, Mirjam Gauri, Windecker, Stephan, Praz, Fabien Daniel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1941-7632

Publisher:

American Heart Association

Language:

English

Submitter:

Pubmed Import

Date Deposited:

07 Mar 2022 09:53

Last Modified:

05 Dec 2022 16:12

Publisher DOI:

10.1161/CIRCINTERVENTIONS.121.011302

PubMed ID:

35236096

Uncontrolled Keywords:

heart failure heart valve diseases stent tricuspid valve tricuspid valve insufficiency

URI:

https://boris.unibe.ch/id/eprint/166579

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