Clin Res Cardiol (2022). https://doi.org/10.1007/s00392-022-02002-5 |
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Analysis of patients´ characteristics which were deemed to be unsuitable for transcatheter tricuspid valve treatment | ||
A. Goncharov1, K. Friedrichs2, T. K. Rudolph2, F. Roder2, V. Rudolph1, M. Gercek2 | ||
1Allgemeine und Interventionelle Kardiologie/Angiologie, Herz- und Diabeteszentrum NRW, Bad Oeynhausen; 2Klinik für Kardiologie, Herz- und Diabeteszentrum NRW, Bad Oeynhausen; | ||
Background Methods Results 76 patients (51.7%) were amenable to TTVT while 71 patients (48.3%) were deemed unsuitable because of clinical futility in 26 (17.7%) cases and morphological/technical criteria in 45 (30.6%) cases. Of the latter, 22 cases (14.9%) were treated surgically, while 23 (15.6%) cases had to be continued on conservative therapy. Reasons for clinical futility were precapillary pulmonary hypertension (8.9%), frailty or limitation of prognosis (4.1%), other cardiac disorders that were found during screening (2.7%) and inappropriate echocardiographic window (2.0%). In the cohort declined due to morphological reasons, overt right ventricle and tricuspid enlargement were the main drivers of rejection. Thus, on multivariate regression analysis, right ventricular basal diameter (p = 0.007, OR 0.93, CI: 0.89 – 0.98), right atrial area (p = 0.016, OR 0.95, CI: 0.92 – 0.99), tricuspid annulus diameter (p = 0.002, OR 0.90, CI: 0.84 – 0.96), coaptation gap (p = 0.023, OR 0.92, CI: 0.86 – 0.99), tethering area (p = 0.004, OR 0.42, CI: 0.24 – 0.76) and coaptation depth (p = 0.005, OR 0.78, CI: 0.66 – 0.93) were identified as independent predictors of rejection for TTVT. 4 (2.7%) patients were declined because of pacemaker lead impingement, 3 (2.0%) patients had no appropriate echocardiographic window. Computed tomography data confirmed a limiting role of the tricuspid anulus size in the choice of therapeutic strategy. Tricuspid annulus area in diastole (p = 0.026, OR 0.15, CI: 0.03 – 0.80), annulus perimeter in diastole (p = 0.035, OR 0.95, CI: 0.91 – 0.99) and max. diastolic distance (p = 0.042, OR 0.64, CI: 0.41 – 0.98) were also identified as independent predictors of rejection for TTVT. Conclusions |
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https://dgk.org/kongress_programme/jt2022/aP1869.html |