Objective:To evaluate the clinical efficacy of transcatheter tricuspid valve replacement(TTVR)for isolated severe tricuspid regurgitation following left-side valve surgery.Methods:From October 2020 to October 2022,seven patients with isolated severe tricuspid regurgitation after left-side valve surgery underwent TTVR at Guangdong Provincial People's Hospital(Guangdong Institute of Cardiovascular Diseases).Among them,five were treated with the Lux-Valve device(via the right atrial pathway),and two with the Lux-Valve Plus device(via the jugular vein pathway).Inpatient treatment and follow-up data were collected for summarizing and analy-zing clinical outcomes.Results:The mean age of the patients was(65.1±8.8)years,with a female predominance(5/7).Five patients(71.4％)exhibited typical right heart failure symptoms such as lower limb edema.All pa-tients had preoperative tricuspid regurgitation of 4+or greater,a median CRS score of 8.0,average Child-Pugh score of 7.3,pulmonary artery systolic pressure of(38.9±10.1)mmHg,fractional area change of right ventricu-lar(42.3±3.6)％,tricuspid annular plane systolic excursion 15.6±1.8 mm.Intraoperatively,the transcatheter tricuspid valve device was successfully placed,with an immediate postoperative device success rate and surgical success rate of 100％(immediate tricuspid regurgitation improvement,2 cases of 1+perivalvular leakage,5 cases with no regurgitation).No complications such as death,thoracotomy conversion,or valve displacement occurred.The mean follow-up time was(14.2±10.2)months,during which the prosthetic tricuspid valve devices all func-tioned well.Only one patient had residual 1+perivalvular leakage,significantly improved compared to preopera-tive conditions(P＜0.001).There were no instances of more than moderate pulmonary hypertension,hepatic ve-nous regurgitation,reoperation,or hospitalization for heart failure.All NYHA cardiac function classes recovered to Class Ⅱ.Conclusion:Transcatheter tricuspid valve replacement is safe and reliable in patients with severe tri-cuspid regurgitation after left-side valve surgery at the early stage of right heart failure.It demonstrates excellent early and mid-term clinical outcomes with a significant improvement in severe tricuspid regurgitation.Future re-search on the specific effects and advantages of TTVR for these patients is still needed.
维普
万方数据