Computed tomography anatomic predictors of outcomes in patients undergoing tricuspid transcatheter edge-to-edge repair.

Bartkowiak, Joanna; Vivekanantham, Hari; Kassar, Mohammad; Dernektsi, Chrisoula; Agarwal, Vratika; Lebehn, Mark; Windecker, Stephan; Brugger, Nicolas; Hahn, Rebecca T; Praz, Fabien (2024). Computed tomography anatomic predictors of outcomes in patients undergoing tricuspid transcatheter edge-to-edge repair. Journal of cardiovascular computed tomography, 18(3), pp. 259-266. Elsevier 10.1016/j.jcct.2024.02.001

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AIM

To identify anatomical computed tomography (CT) predictors of procedural and clinical outcomes in patients undergoing tricuspid transcatheter edge-to-edge repair (T-TEER).

METHODS AND RESULTS

Consecutive patients undergoing T-TEER between March 2018 to December 2022 who had cardiac CT prior to the procedure were included. CT scans were automatically analyzed using a dedicated software that employs deep learning techniques to provide precise anatomical measurements and volumetric calculations. Technical success was defined as successful placement of at least one implant in the planned anatomic location without single leaflet device attachment. Procedural success was defined as tricuspid regurgitation reduction to moderate or less. Procedural complexity was assessed by measuring the fluoroscopy time. The clinical endpoint was a composite of death, heart failure hospitalization, or tricuspid re-intervention throughout two years. A total of 33 patients (63.6% male) were included. Procedural success was achieved in 22 patients (66.7%). Shorter end-systolic (ES) height between the inferior vena cava (IVC) and tricuspid annulus (TA) (r ​= ​- 0.398, p ​= ​0.044) and longer ES RV length (r ​= ​0.551, p ​= ​0.006) correlated with higher procedural complexity. ES RV length was independently associated with lower technical(adjusted Odds ratio [OR] 0.812 [95% CI 0.665-0.991], p ​= ​0.040) and procedural success (adjusted OR 0.766, CI [0.591-0.992], p ​= ​0.043). Patients with ES right ventricular (RV) length of >77.4 ​mm had a four-fold increased risk of experiencing the composite clinical endpoint compared to patients with ES RV length ≤77.4 ​mm (HR ​= ​3.964 [95% CI, 1.018-15.434]; p ​= ​0,034]).

CONCLUSION

CT-derived RV length and IVC-to-TA height may be helpful to identify patients at increased risk for procedural complexity and adverse outcomes when undergoing T-TEER. CT provides valuable information for preprocedural decision-making and device selection.

Item Type:

Journal Article (Original Article)

Division/Institute:

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

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Vivekanantham, Hari, Kassar, Mohammad, Dernektsi, Chrisoula, Windecker, Stephan, Brugger, Nicolas Jacques, Praz, Fabien Daniel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1876-861X

Publisher:

Elsevier

Language:

English

Submitter:

Pubmed Import

Date Deposited:

22 Feb 2024 12:53

Last Modified:

01 May 2024 00:14

Publisher DOI:

10.1016/j.jcct.2024.02.001

PubMed ID:

38383226

BORIS DOI:

10.48350/193156

URI:

https://boris.unibe.ch/id/eprint/193156

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