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December 18, 2023Current Opinion in Cardiology

Transcatheter edge-to-edge repair and replacement improve quality of life compared to medical therapy for high-surgical-risk patients with severe symptomatic tricuspid regurgitation.

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Why the study?

Unique pathophysiologic considerations of severe tricuspid regurgitation have prompted advancements in surgical and transcatheter treatments, motivating a review of current interventions for functional disease.

Do surgical and transcatheter tricuspid valve interventions improve outcomes in patients with severe tricuspid regurgitation and heart failure?

Design

Review

Key result

Transcatheter edge-to-edge repair and replacement improve quality of life compared to medical therapy for high-surgical-risk patients with severe symptomatic tricuspid regurgitation.

Authors

VCVincent ChenOAOmar Abdul‐Jawad AltisentRPRishi Puri

Discussion

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Member takes

Overview

Ring annuloplasty may yield better surgical outcomes than replacement for functional TR; leaves open optimal patient selection and TTVI integration.

Structured PICO

Do surgical and transcatheter tricuspid valve interventions improve outcomes in patients with severe tricuspid regurgitation and heart failure?

P
Population
Patients with severe tricuspid regurgitation and heart failure
I
Intervention
Surgical and transcatheter tricuspid valve interventions (including ring annuloplasty, transcatheter edge-to-edge repair [T-TEER], transcatheter replacement [TTVR], and caval valve implantation [CAVI])
C
Comparator
Medical therapy alone or alternative surgical approaches (e.g., surgical replacement)

Transcatheter tricuspid valve interventions provide a crucial treatment option that improves quality of life for high-surgical-risk patients with severe tricuspid regurgitation, addressing a gap left by high-risk surgical options.

Limitations

  • Surgical uptake of TR correction remains relatively low.
  • Operative mortality rates are still high owing to multiple comorbidities and advanced disease at the time of referral.
  • Clinical outcomes after surgical TV intervention are poor, often due to intervening late in the disease course.

Cite This Study

Chen et al. (2023) conducted a review in Severe tricuspid regurgitation (TR) in patients with heart failure. Surgical and transcatheter tricuspid valve interventions (TTVI) vs. Medical therapy alone was evaluated. Transcatheter edge-to-edge repair and replacement improve quality of life compared to medical therapy for high-surgical-risk patients with severe symptomatic tricuspid regurgitation.

synapsesocial.com/papers/6a9a7f305804b0b5899e4ea5https://doi.org/10.1097/hco.0000000000001110
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