The natural history of tricuspid regurgitation is associated to hospitalization for cardiac failure and mortality. This is why the AHA/ACC guidelines recommend surgery when the tricuspid fails during left valve surgical repair, because its slow progression is associated with high mortality (35%). Many of these patients are high risk and percutaneous intervention has surged as...
Edge-to-edge treatment has proven to be a safe and effective technique in follow-up, decreasing mortality and hospitalizations for heart failure when a good result is achieved. The MitraScore was developed to assess the outcome at the end of the procedure. In that sense, results <3 represent mild mitral regurgitation, which would be related to lower...
Survival analysis of patients with tricuspid regurgitation grouped according to comorbidities and echocardiographic variables. For many years, the tricuspid was classified as the “forgotten valve,” due to the scarce possibility of treatment beyond symptom control in patients with heart failure. However, in recent years, there has been an improvement in the treatment of the valve...
Severe tricuspid regurgitation (TR) is difficult to manage and is associated to high morbimortality. Surgical repair is complex and not free from complications: its mortality rate ranges from 5 to 20% and depends on series, surgeon and center expertise. Edge-to-edge repair with clips has become a valid alternative to treat this disease, but most data...
Tricuspid regurgitation is a common and impairing disease. Optimal medical therapy (OMT) is limited, valve surgery is complex, and mortality is not low. Dr. Paul Sorajja presented the results of the Pivotal Triluminate study to demonstrate the safety and efficacy of edge-to-edge treatment (transcatheter edge-to-edge repair, TEER) in tricuspid regurgitation. Three hundred and fifty patients...
The five year outcomes of the multicenter open label COAPT (Cardiovascular Outcomes Assessment of the MitraClip Percutaneous Therapy for Heart Failure Patients with Functional Mitral Regurgitation) were presented at ACC 2023; it included 614 patients with cardiac failure (CF) and moderate to severe (3+/4+) symptomatic secondary mitral regurgitation, despite medical therapy. Patients were randomized 1:1...
We are already familiar with the strong impact of secondary mitral valve regurgitation (SMR) in survival and quality of life. Most of these patients present heart failure (HF) with reduced ejection fraction (HFrEF). Stages of heart failure based on extra-mitral cardiac involvement has been shown relevant. There is also extensive research on aortic valve disease...
At present, cardiogenic shock continues to present high mortality despite the new treatments and ventricular assistance devices available in some centers. In this group, the presence of severe mitral regurgitation (MR) is around 5% and, on many occasions, it cannot be treated with surgery because of hemodynamic conditions. Edge-to-edge repair has been looked at by...
Severe secondary mitral valve regurgitation is associated to hospitalization and mortality. The COAPT study has shown the superiority of guideline directed medical therapy at maximal tolerated doses according to guidelines (GDMT) plus edge-to-edge transcatheter repair (TEER) versus GMDT alone. However, at present there is no information on the impact of hospitalizations and their relationship to...
The CLASP IID study was a prospective randomized study to assess the efficacy and effectiveness of the PASCAL transcatheter valve repair system compared with the MitraClip device for patients with degenerative mitral regurgitation (MR) at prohibitive surgical risk. The study included Patients at prohibitive surgical risk, candidates for both devices, with MR 3+ to 4+,...