Guillem Muntané-Carol1, Maurizio Taramasso2, Mizuki Miura2, Mara Gavazzoni2, Alberto Pozzoli2, Hannes Alessandrini3, Azeem Latib4, Adrian Attinger-Toller5, Luigi Biasco6, Daniel Braun7, Eric Brochet8, Kim A Connelly9, Horst Sievert10, Paolo Denti11, Edith Lubos12, Sebastian Ludwig12, Daniel Kalbacher12, Rodrigo Estevez-Loureiro13, Neil Fam9, Christian Frerker3, Edwin Ho14, Jean-Michel Juliard8, Ryan Kaple15, Susheel Kodali16, Felix Kreidel17, Claudia Harr3, Alexander Lauten18, Julia Lurz19, Karl-Patrik Kresoja19, Vanessa Monivas13, Michael Mehr7, Tamim Nazif16, Georg Nickening20, Giovanni Pedrazzini6, François Philippon1, Fabien Praz21, Rishi Puri1, Ulrich Schäfer12, Joachim Schofer22, Gilbert H L Tang23, Ahmed A Khattab24, Martin Andreas25, Marco Russo25, Holger Thiele19, Matthias Unterhuber19, Dominique Himbert8, Marina Urena8, Ralph Stephan von Bardeleben17, John G Webb5, Marcel Weber20, Mirjam Winkel21, Michel Zuber2, Jörg Hausleiter7, Philipp Lurz19, Francesco Maisano2, Martin B Leon16, Rebecca T Hahn16, Josep Rodés-Cabau26. 1. Cardiology Department, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada. 2. Cardiology Department, University Hospital of Zurich, University of Zurich, Zurich, Switzerland. 3. Cardiology Department, Asklepios Klinik St Georg, Hamburg, Germany. 4. Cardiology Department, Montefiore Medical Center, New York, New York, USA. 5. Cardiology Department, St Paul Hospital, Vancouver, British Columbia, Canada. 6. Cardiology Department, Cardiocentro, Lugano, Switzerland. 7. Cardiology Department, Klinikum der Universität München, Munich, Germany. 8. Cardiology Department, Hôpital Bichat, Université Paris VI, Paris, France. 9. Cardiology Department, Toronto Heart Center, St Michael's Hospital, Toronto, Ontario, Canada. 10. Cardiology Department, Cardiovascular Center Frankfurt, Frankfurt am Main, Germany. 11. Cardiac Surgery Department, San Raffaele University Hospital, Milan, Italy. 12. Cardiology Department, University Heart Center Hamburg, Hamburg, Germany. 13. Cardiology Department, Department of Cardiology, Hospital Universitario Puerta de Hierro, Madrid, Spain. 14. Cardiology Department, Montefiore Medical Center, New York, New York, USA; Cardiology Department, Toronto Heart Center, St Michael's Hospital, Toronto, Ontario, Canada. 15. Cardiology Department, Westchester Medical Center, Valhalla, New York, USA. 16. Cardiology Department, New York-Presbyterian/Columbia University Medical Center, New York, New York, USA. 17. Cardiology Department, Department of Cardiology, University Medical Center Mainz, Mainz, Germany. 18. Cardiology Department, Charité University Hospital, Berlin, Germany. 19. Cardiology Department, Heart Center Leipzig, University Hospital Leipzig, Leipzig, Germany. 20. Cardiology Department, Universitatsklinikum Bonn, Bonn, Germany. 21. Cardiology Department, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. 22. Cardiology Department, Albertinen Heart Center, Hamburg, Germany. 23. Cardiac Surgery Department, Mount Sinai Hospital, New York, New York, USA. 24. Cardiology Department, University Hospital of Zurich, University of Zurich, Zurich, Switzerland; Cardiology Department, Cardiance Clinic, Pfäffikon, Switzerland; Cardiology Department, University of Bern, Bern, Switzerland. 25. Division of Cardiac Surgery, Department of Surgery, Medical University of Vienna, Vienna, Austria. 26. Cardiology Department, Québec Heart and Lung Institute, Laval University, Québec City, Québec, Canada. Electronic address: josep.rodes@criucpq.ulaval.ca.
Abstract
BACKGROUND: Scarce data exist on patients with previous left valve surgery (PLVS) undergoing transcatheter tricuspid valve intervention (TTVI). This study sought to investigate the procedural and early outcomes in patients with PLVS undergoing TTVI. METHODS: This was a subanalysis of the multicenter TriValve registry including 462 patients, 82 (18%) with PLVS. Data were analyzed according to the presence of PLVS in the overall cohort and in a propensity score-matched population including 51 and 115 patients with and without PLVS, respectively. RESULTS: Patients with PLVS were younger (72 ± 10 vs 78 ± 9 y; p < 0.01) and more frequently female (67.1% vs 53.2%; P = 0.02). Similar rates of procedural success (PLVS 80.5%; no-PLVS 82.1%; P = 0.73), and 30-day mortality (PLVS 2.4%, no-PLVS 3.4%; P = 0.99) were observed. After matching, there were no significant differences in both all-cause rehospitalisation (PLVS 21.1%, no-PLVS 26.5%; P = 0.60) and all-cause mortality (PLVS 9.8%, no-PLVS 6.7%; P = 0.58). At last follow-up (median 5.7 [interquartile range 1.4-11.9] mo after the procedure), most patients (81.8%) in the PLVS group were in NYHA functional class I-II (P = 0.12 vs no-PLVS group), and TR grade was ≤ 2 in 82.6% of patients (P = 0.096 vs no-PVLS group). CONCLUSIONS: In patients with PLVS, TTVI was associated with high rates of procedural success and low early mortality. However, about one-third of patients required rehospitalisation or died at midterm follow-up. These results would support TTVI as a reasonable alternative to redo surgery in patients with PLVS and suggest the importance of earlier treatment to improve clinical outcomes.
BACKGROUND: Scarce data exist on patients with previous left valve surgery (PLVS) undergoing transcatheter tricuspid valve intervention (TTVI). This study sought to investigate the procedural and early outcomes in patients with PLVS undergoing TTVI. METHODS: This was a subanalysis of the multicenter TriValve registry including 462 patients, 82 (18%) with PLVS. Data were analyzed according to the presence of PLVS in the overall cohort and in a propensity score-matched population including 51 and 115 patients with and without PLVS, respectively. RESULTS:Patients with PLVS were younger (72 ± 10 vs 78 ± 9 y; p < 0.01) and more frequently female (67.1% vs 53.2%; P = 0.02). Similar rates of procedural success (PLVS 80.5%; no-PLVS 82.1%; P = 0.73), and 30-day mortality (PLVS 2.4%, no-PLVS 3.4%; P = 0.99) were observed. After matching, there were no significant differences in both all-cause rehospitalisation (PLVS 21.1%, no-PLVS 26.5%; P = 0.60) and all-cause mortality (PLVS 9.8%, no-PLVS 6.7%; P = 0.58). At last follow-up (median 5.7 [interquartile range 1.4-11.9] mo after the procedure), most patients (81.8%) in the PLVS group were in NYHA functional class I-II (P = 0.12 vs no-PLVS group), and TR grade was ≤ 2 in 82.6% of patients (P = 0.096 vs no-PVLS group). CONCLUSIONS: In patients with PLVS, TTVI was associated with high rates of procedural success and low early mortality. However, about one-third of patients required rehospitalisation or died at midterm follow-up. These results would support TTVI as a reasonable alternative to redo surgery in patients with PLVS and suggest the importance of earlier treatment to improve clinical outcomes.