Outcomes of TTVI in Patients With Pacemaker or Defibrillator Leads: Data From the TriValve Registry.

Aged, 80 and over Cardiac Catheterization / adverse effects Cardiac Pacing, Artificial / adverse effects Clinical Decision-Making Defibrillators, Implantable Electric Countershock / adverse effects Europe Feasibility Studies Female Heart Valve Prosthesis Heart Valve Prosthesis Implantation / adverse effects Hemodynamics Hospital Mortality Humans Male Mitral Valve / diagnostic imaging Mitral Valve Insufficiency / diagnostic imaging North America Pacemaker, Artificial Postoperative Complications / etiology Prosthesis Design Recovery of Function Registries Retrospective Studies Risk Factors Time Factors Treatment Outcome

transcatheter tricuspid intervention tricuspid regurgitation tricuspid valve

Journal

JACC. Cardiovascular interventions

ISSN: 1876-7605

Titre abrégé: JACC Cardiovasc Interv

Pays: United States

ID NLM: 101467004

Informations de publication

Date de publication:
09 03 2020

Historique:

received: 29 07 2019

revised: 30 09 2019

accepted: 09 10 2019

pubmed: 20 1 2020

medline: 21 10 2020

entrez: 20 1 2020

Statut: ppublish

Résumé

The interference of a transtricuspid cardiac implantable electronic device (CIED) lead with tricuspid valve function may contribute to the mechanism of tricuspid regurgitation (TR) and poses specific therapeutic challenges during transcatheter tricuspid valve intervention (TTVI). Feasibility and efficacy of TTVI in presence of a CIED is unclear. Feasibility of TTVI in presence of a CIED lead has never been proven on a large basis. The study population consisted of 470 patients with severe symptomatic TR from the TriValve (Transcatheter Tricuspid Valve Therapies) registry who underwent TTVI at 21 centers between 2015 and 2018. The association of CIED and outcomes were assessed. Pre-procedural CIED was present in 121 of 470 (25.7%) patients. The most frequent location of the CIED lead was the posteroseptal commissure (44.0%). As compared with patients without a transvalvular lead (no-CIED group), patients having a tricuspid lead (CIED group) were more symptomatic (New York Heart Association functional class III to IV in 95.9% vs. 92.3%; p = 0.02) and more frequently had previous episodes of right heart failure (87.8% vs. 69.0%; p = 0.002). No-CIED patients had more severe TR (effective regurgitant orifice area 0.7 ± 0.6 cm TTVI is feasible in selected patients with CIED leads and acute procedural success and short-term clinical outcomes are comparable to those observed in patients without a transtricuspid lead.

Sections du résumé

OBJECTIVES

BACKGROUND

Feasibility of TTVI in presence of a CIED lead has never been proven on a large basis.

METHODS

The study population consisted of 470 patients with severe symptomatic TR from the TriValve (Transcatheter Tricuspid Valve Therapies) registry who underwent TTVI at 21 centers between 2015 and 2018. The association of CIED and outcomes were assessed.

RESULTS

Pre-procedural CIED was present in 121 of 470 (25.7%) patients. The most frequent location of the CIED lead was the posteroseptal commissure (44.0%). As compared with patients without a transvalvular lead (no-CIED group), patients having a tricuspid lead (CIED group) were more symptomatic (New York Heart Association functional class III to IV in 95.9% vs. 92.3%; p = 0.02) and more frequently had previous episodes of right heart failure (87.8% vs. 69.0%; p = 0.002). No-CIED patients had more severe TR (effective regurgitant orifice area 0.7 ± 0.6 cm

CONCLUSIONS

TTVI is feasible in selected patients with CIED leads and acute procedural success and short-term clinical outcomes are comparable to those observed in patients without a transtricuspid lead.

Identifiants

DOI: 10.1016/j.jcin.2019.10.058 PMID: 31954676

pubmed: 31954676

pii: S1936-8798(19)32396-9

doi: 10.1016/j.jcin.2019.10.058

pii:

doi:

Types de publication

Journal Article Multicenter Study

Langues

eng

Sous-ensembles de citation

Pagination

554-564

Commentaires et corrections

Type : CommentIn