Transjugular Transcatheter Tricuspid Valve Replacement: Early Compassionate Use Outcomes
Recommended Citation
Stolz L, Cheung A, Boone R, Fam N, Ong G, Villablanca P, Jabri A, De Backer O, Mølller JE, Tchétché D, Oliva O, Chak-Yu So K, Lam YY, Latib A, Scotti A, Coisne A, Sudre A, Dreyfus J, Nejjari M, Favre PE, Cruz-Gonzalez I, Estévez-Loureiro R, Barreiro-Perez M, Makkar R, Patel D, Leurent G, Donal E, Modine T, and Hausleiter J. Transjugular Transcatheter Tricuspid Valve Replacement: Early Compassionate Use Outcomes. JACC Cardiovasc Interv 2024; 17(16):1936-1945.
Document Type
Article
Publication Date
8-26-2024
Publication Title
JACC Cardiovasc Interv
Keywords
Humans, Female, Male, Retrospective Studies, Aged, Treatment Outcome, Time Factors, Registries, Aged, 80 and over, Heart Valve Prosthesis, Tricuspid Valve, Compassionate Use Trials, Tricuspid Valve Insufficiency, Heart Valve Prosthesis Implantation, Cardiac Catheterization, Prosthesis Design, Risk Factors, Recovery of Function, Hospital Mortality, Postoperative Complications, Jugular Veins
Abstract
BACKGROUND: Data on procedural and early outcomes after transjugular transcatheter tricuspid valve replacement (TTVR) are limited.
OBJECTIVES: This study sought to evaluate first-in-man procedural and clinical outcomes after transjugular TTVR with a special focus on patients who received large device sizes in whom TTVR outcomes have been questioned.
METHODS: The retrospective registry included patients who underwent TTVR using the LuX-Valve Plus system (Jenscare Biotechnology Co Ltd) for symptomatic tricuspid regurgitation (TR) from January 2022 until February 2024 at 15 international centers in a compassionate use setting. The endpoints were procedural TR reduction, in-hospital death, adverse events, and 1-month survival. We further stratified results according to the size of the implanted device (≥55 mm).
RESULTS: The registry included a total of 76 patients at a median age of 78 years (Q1-Q3: 72-83 years, 47.4% women). TR was reduced to ≤2+ and ≤1+ in 94.7% and 90.8% of patients (75.0% of patients received TTVR devices ≥55 mm) with well-sustained results at 1-month follow-up (TR ≤2+ in 95.0% and ≤1+ 86.8%). Residual TR was paravalvular in all cases. In-hospital death occurred in 4 patients (5.3%). Four patients (5.3%) underwent cardiac surgery during index hospitalization. Major in-hospital bleeding events occurred in 5 patients (6.6%). New in-hospital pacemaker implantation was required in 3.9% of patients in the overall cohort (5.7% in "pacemaker-naive" individuals). No cases of valve thrombosis, stroke, myocardial infarction, or pulmonary embolism were observed. At 1-month follow-up, survival was 94.4%, and NYHA functional class significantly improved. One further patient received a pacemaker, 1 further bleeding event occurred, and 2 patients underwent reintervention or surgery within the first 30 days after TTVR. No differences in procedural outcomes or adverse events were observed after stratification for valve size.
CONCLUSIONS: Transjugular TTVR appears to be a safe and effective treatment option for patients with severe TR with comparable outcomes in very large tricuspid anatomies.
Medical Subject Headings
Humans; Female; Male; Retrospective Studies; Aged; Treatment Outcome; Time Factors; Registries; Aged, 80 and over; Heart Valve Prosthesis; Tricuspid Valve; Compassionate Use Trials; Tricuspid Valve Insufficiency; Heart Valve Prosthesis Implantation; Cardiac Catheterization; Prosthesis Design; Risk Factors; Recovery of Function; Hospital Mortality; Postoperative Complications; Jugular Veins
PubMed ID
39197992
Volume
17
Issue
16
First Page
1936
Last Page
1945
