Tricuspid failure is a prevalent valvulopathy most often mistreated. It has been associated with high surgical risk and medical treatment has showed substandard therapeutic effect.
Surgical repair with valve annuloplasty is the technique of choice for its long-term durability. Transcatheter repair of the tricuspid valve is an alternative that aims at imitating annuloplasty by reducing annulus diameter to facilitate better valve coaptation.
A multicenter single arm study was conducted aiming at assessing the effectiveness and safety of the Cardioband safety system in the treatment of functional tricuspid failure.
37 patients with tricuspid failure were included, at least moderate, symptomatic despite optimal medical treatment, with appropriate anatomy for the procedure.
Primary end point was absence of adverse events associated to the procedure at 30 days, followed up for one year.
Read also: EuroPCR 2022 | The IMPROVED-CTO Trial.
Patients were mean age 78±7.5, 76% were women, all of them presented severe tricuspid failure (60% torrential) and 73% pulmonary hypertension.
When looking at major cardiovascular events, there was 8% cardiovascular mortality (unrelated to the procedure) mainly high rate of severe bleeding, both at 30 days (21%) and one year (35%), and 10% of rehospitalization for cardiac failure.
The technique was shown effective, with 21% tricuspid annulus diameter reduction, which meant 73% reduction in tricuspid failure moderate to severe. Functional class was also improved (dyspnea in functional class CF I or II in 92% of patients).
Conclusions
Tricuspid repair with Cardioband showed high survival rate with low number of hospitalizations for cardiac failure. At one-year followup, there was significant tricuspid failure reduction and improved quality of life compared to baseline values.
Dr. Omar Tupayachi.
Member of the Editorial Board of SOLACI.org.
Source: Presented by Late-breaking clinical trial en EuroPCR 2022 por Dr William Gray.
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