Adam B Greenbaum1,2, Jaffar M Khan3,4, Toby Rogers3,4, Vasilis C Babaliaros1, Marvin H K Eng2, Dee Dee Wang2, Gaetano Paone2, Robert J Lederman3. 1. Divisions of Cardiology and Cardiac Surgery, Structural Heart and Valve Center, Emory University Hospital, Atlanta, Georgia, USA. 2. Henry Ford Health System, Detroit, Michigan, USA. 3. Cardiovascular Branch, Division of Intramural Research, National Heart Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA. 4. Medstar Washington Hospital Center, Washington, District of Columbia, USA.
Abstract
OBJECTIVES: We report the first pledget-assisted suture tricuspid annuloplasty (PASTA) in a patient with torrential tricuspid regurgitation (TR). BACKGROUND: Tricuspid valve regurgitation is a common malignant disease with no commercially available transcatheter therapy. PASTA is a "percutaneous surgical" procedure using pledgeted sutures to create a double-orifice tricuspid valve. METHODS: An 83-year-old man had end-stage TR caused by a defibrillator lead. He consented to undergo PASTA on a compassionate basis. A double-orifice valve was created with pledgeted sutures from percutaneous right ventricular apical access. RESULTS: TR was reduced from torrential to trace. The vena contracta reduced to from 23 to 1 mm and annular area reduced from 1817 to 782 mm2 . However, the annulus dehisced and required closure with a percutaneous nitinol plug. The patient was discharged home and was alive 6 months later but with persistent symptoms. CONCLUSIONS: The anatomy of a double-orifice valve can eliminate TR but a better solution is required to avoid excessive suture tension on annular tissue. Published 2020. This article is a U.S. Government work and is in the public domain in the USA.
OBJECTIVES: We report the first pledget-assisted suture tricuspid annuloplasty (PASTA) in a patient with torrential tricuspid regurgitation (TR). BACKGROUND: Tricuspid valve regurgitation is a common malignant disease with no commercially available transcatheter therapy. PASTA is a "percutaneous surgical" procedure using pledgeted sutures to create a double-orifice tricuspid valve. METHODS: An 83-year-old man had end-stage TR caused by a defibrillator lead. He consented to undergo PASTA on a compassionate basis. A double-orifice valve was created with pledgeted sutures from percutaneous right ventricular apical access. RESULTS: TR was reduced from torrential to trace. The vena contracta reduced to from 23 to 1 mm and annular area reduced from 1817 to 782 mm2 . However, the annulus dehisced and required closure with a percutaneous nitinol plug. The patient was discharged home and was alive 6 months later but with persistent symptoms. CONCLUSIONS: The anatomy of a double-orifice valve can eliminate TR but a better solution is required to avoid excessive suture tension on annular tissue. Published 2020. This article is a U.S. Government work and is in the public domain in the USA.
Authors: Jaffar M Khan; Toby Rogers; William H Schenke; Adam B Greenbaum; Vasilis C Babaliaros; Gaetano Paone; Rajiv Ramasawmy; Marcus Y Chen; Daniel A Herzka; Robert J Lederman Journal: Catheter Cardiovasc Interv Date: 2018-02-06 Impact factor: 2.692
Authors: Rebecca T Hahn; Christopher U Meduri; Charles J Davidson; Scott Lim; Tamim M Nazif; Mark J Ricciardi; Vivek Rajagopal; Gorav Ailawadi; Mani A Vannan; James D Thomas; Dale Fowler; Stuart Rich; Randy Martin; Geraldine Ong; Adam Groothuis; Susheel Kodali Journal: J Am Coll Cardiol Date: 2017-04-11 Impact factor: 24.094
Authors: Alberto Alperi; Marcel Almendárez; Rut Álvarez; Cesar Moris; Victor Leon; Iria Silva; Daniel Hernández-Vaquero; Isaac Pascual; Pablo Avanzas Journal: Front Cardiovasc Med Date: 2022-09-14