Comparison of transcatheter leaflet-approximation and direct annuloplasty in tricuspid regurgitation
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Published:2023-08-29
Issue:1
Volume:113
Page:126-137
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ISSN:1861-0684
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Container-title:Clinical Research in Cardiology
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language:en
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Short-container-title:Clin Res Cardiol
Author:
Ochs LaurinORCID, Körber Maria Isabel, Wienemann Hendrik, Tichelbäcker Tobias, Iliadis Christos, Metze Clemens, Brüwer Monique, Schmidt Tobias, Omran Hazem, Fortmeier Vera, Friedrich Kai, Rudolph Volker, Baldus Stephan, Pfister Roman
Abstract
Abstract
Background
Transcatheter repair emerges as a treatment option in patients with tricuspid regurgitation (TR) and high surgical risk.
Aims
This study aimed to compare leaflet-based and annuloplasty-based transcatheter repair in patients with TR.
Methods
In a retrospective analysis consecutive patients undergoing either transcatheter edge-to-edge repair (TEER) or direct annuloplasty (AP) for relevant TR at 2 centers were compared with respect to baseline characteristics, procedural efficacy and safety (death, myocardial infarction, procedure or device-related cardiothoracic surgery, or stroke at 30 days).
Results
161 patients (57% female, median age 79 [75–82] years) with comparable clinical baseline characteristics in the TEER (n = 87) and AP (n = 74) group were examined. Baseline TR grade was significantly less severe in the TEER compared to the AP group (torrential 9.2 vs. 31.1%, p = 0.001). Technical success and improvement of TR grades were not significantly different across groups. In analysis matched for baseline TR severity, reduction of TR grade to less than moderate was significantly more common in the AP group (47.8 vs. 26.1%, p = 0.031). Major or more severe bleeding occurred in 9.2% of TEER and 20.3% of AP patients (p = 0.049) without any fatal bleedings. Major adverse events (MAE) were similar across groups with four patients (4.7%) in the TEER group and five patients (6.9%) in the AP group (p = 0.733) and 6-month survival did not differ significantly.
Conclusions
Differences observed between patients treated with TEER and AP provide first evidence for tailoring distinct transcatheter treatment techniques to individual patient characteristics.
Graphic abstract
Funder
Universitätsklinikum Köln
Publisher
Springer Science and Business Media LLC
Subject
Cardiology and Cardiovascular Medicine,General Medicine
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