Transcatheter treatment for tricuspid valve disease
- PMID: 34796878
- PMCID: PMC9724890
- DOI: 10.4244/EIJ-D-21-00695
Transcatheter treatment for tricuspid valve disease
Abstract
Approximately 4% of subjects aged 75 years or more have clinically relevant tricuspid regurgitation (TR). Primary TR results from anatomical abnormality of the tricuspid valve apparatus and is observed in only 8-10% of the patients with tricuspid valve disease. Secondary TR is more common and arises as a result of annular dilation caused by right ventricular enlargement and dysfunction as a consequence of pulmonary hypertension, often caused by left-sided heart disease or atrial fibrillation. Irrespective of its aetiology, TR leads to volume overload and increased wall stress, both of which negatively contribute to detrimental remodelling and worsening TR. This vicious circle translates into impaired survival and increased heart failure symptoms in patients with and without reduced left ventricular ejection fraction. Interventions to correct TR are underutilised in daily clinical practice owing to increased surgical risk and late patient presentation. The recently introduced transcatheter tricuspid valve interventions aim to address this unmet need. Dedicated expertise and an interdisciplinary Heart Team evaluation are essential to integrate these new techniques successfully and select patients. The present article proposes a standardised approach to evaluate patients with TR who may be candidates for transcatheter interventions. In addition, a state-of-the-art review of the available transcatheter therapies, the main criteria for patient and device selection, and information concerning the remaining uncertainties are provided.
Conflict of interest statement
F. Praz has received travel expenses from Abbott Vascular, Edwards Lifesciences, and Polares Medical. D. Muraru is part of the speaker’s bureau for GE Healthcare and received research equipment support from GE Vingmed. F. Kreidel has received speaker’s honoraria from Abbott Vascular. P. Lurtz has served as a consultant for Abbott Structural Heart, Edwards Lifesciences, and Medtronic. R. Hahn has received speaker fees from Boston Scientific, Baylis Medical, Edwards Lifescience and Medtronic, consulting fees for Abbott Structural, Edwards Lifesciences, Gore&Associates, Medtronic, Navigate, and Philips Healthcare, non-financial support from 3mensio, has equity with Navigate, and is the Chief Scientific Officer for the Echocardiography Core Laboratory at the Cardiovascular Research Foundation for multiple industry-sponsored trials, for which she receives no direct industry compensation. V. Delgado has received speaker fees from Abbott Vascular, Edwards Lifesciences, GE Healthcare, Novartis, MSD and Medtronic. M. Senni has received personal fees from Novartis during the conduct of the study and personal fees from Bayer, Abbott, Merck, AstraZeneca, Vifor Pharma and Boehringer outside the submitted work. R.S. von Bardeleben is a consultant for Abbott Vascular. G. Nickenig has received research funding from the Deutsche Forschungsgemeinschaft, the German Federal Ministry of Education and Research, the EU, Abbott, Edwards Lifesciences, Medtronic, and St. Jude Medical, and has received honoraria for lectures or advisory boards from Abbott, Edwards Lifesciences, Medtronic, and St. Jude Medical. J. Hausleiter has received speaker honoraria from Abbott Vascular and Edwards Lifesciences. A. Mangieri has received an institutional grant from Boston Scientific and is part of the advisory board of Boston -Scientific. J. Zamorano has received speaker honoraria from -Daichii Sankyo and Pfizer. B. Prendergast has received unrestricted educational and research grants from Edwards -Lifesciences and speaker/consultancy fees from Edwards Lifesciences, Abbott, and Anteris. F. Maisano reports grant and/or research institutional support from Abbott, Medtronic, Edwards Lifesciences, Biotronik, Boston Scientific Corporation, NVT, and Terumo, consulting fees, honoraria (personal and institutional) from Abbott, Medtronic, Edwards Lifesciences, Xeltis, Cardiovalve, Occlufit, Simulands, has royalty income/IP rights from Edwards Lifesciences, and is a shareholder (including share options) of Cardiogard, Magenta, SwissVortex, Transseptalsolutions, Occlufit, 4Tech, and Perifect. M. Adamo has no conflicts of interest to declare. M. Andreas reports receiving grants and fees from Edwards Lifesciences, Abbott, and Medtronic. L. Badano reports receiving consulting fees from Edwards Lifesciences, Esaote, and Jansen, and speaker fees from GE Healthcare, Esaote, and Philips. S. Baldus reports receiving a research grant Abbott, and speaker fees from Abbott and Edwards. M. Barreiro reports receiving speaker fees Abbott Vascular, Philips Healthcare and Boston Scientific. J. Bax reports receiving speaker fees Edwards Lifesciences and Abbott. M. Borger reports that his hospital receives consulting fees and/or speakers' honoraria on his behalf from Edwards Lifesciences, Medtronic, Abbott and CryoLife. J. Cavalcante reports receiving consulting fees Edwards Lifesciences, Abbott Structural, Medtronic, Inc., Boston Scientific, and VDYNE. L. Conradi reports receiving consulting and speaker fees from Edwards -Lifesciences, Boston Scientific, Medtronic, and Abbott. P. Denti reports receiving a consulting fee from InnovHeart, and speaker fees from Abbott and Edwards. E. Donal reports receiving speaker fees from Abbott Vascular, Philips Healthcare and Boston -Scientific. G. Dreyfus reports being a consultant from Edwards -Lifesciences. N. Dumonteil reports receiving consulting and speaker fees from Abbott Vascular, Ancora Heart, Boston Scientific, Edwards -Lifesciences, and Medtronic. A. Duncan reports lectures/presentations for Abbott Vascular, Edwards Lifesciences, and -Boston Scientific. R. Estevez-Loureiro reports receiving speaker fees Abbott Vascular, Edwards Lifesciences, and Boston Scientific. N. Fam has no conflicts of interest to declare. L. Fiocca has no conflicts of interest to declare. X. Freixa reports receiving consulting and speaker fees from Abbott Vascular. K. Friedrichs reports receiving grants from Edwards Lifesciences. M. Gavazzoni reports receiving personal fees from Abbott Vascular. J. Grapsa has no conflicts of interest to declare. C. Grasso reports receiving fees from Abbott Medical, Boston Scientific, and Edwards -Lifesciences. A. Guidotti has no conflicts of interest to declare. E. Ho reports receiving support for attending meetings from Abbott, Edwards Lifesciences, and Medtronic. N. Karam reports receiving consulting fees from Abbott, Edwards Lifesciences, and Medtronic, and speaker fees from Edwards Lifesciences. R. Lange reports receiving consulting fees and royalties from Medtronic. A. Latib reports receiving consulting fees from Edwards -Lifesciences, Abbott, Medtronic, and Boston Scientific. S. Lim reports receiving grants from Abbott Vascular and Edwards -Lifesciences. C. Lotan has no conflicts of interest to declare. M. Metra reports receiving consulting fees from Amgen, -AstraZeneca, Servier, Vifor Pharma, and WindTree Therapeutics, and speaker fees from Abbott Vascular, and Edwards Therapeutics. T. Modine is a consultant for Boston Scientific, Medtronic, Edwards, MicroPort, GE, and Abbott, and has received a research support grant from Edwards. H. Möllmann reports receiving consulting and speaker fees from Abbott Vascular, Boston Scientific and Edwards Lifesciences. L. Ortega-Paz has no conflicts of interest to declare. N. Piazza reports receiving consulting fees from Medtronic, Peijia Medical, and Highlife. W. Rottbauer reports receiving funding for this ms from Edwards Lifesciences, and consulting fees from Edwards Lifesciences and Abbott. V. Rudolph reports receiving grants from Edwards Lifesciences and Abbott Vascular. M. Sarano has no conflicts of interest to declare. M. Sitges reports receiving grants from Abbott, Medtronic, and Edward Lifesciences, and consulting and speaker fees from Abbott, Medtronic, and Edwards Lifesciences. O. Soliman has no conflicts of interest to declare. L. Sondergaard reports receiving consulting and speaker fees from Abbott, Boston Scientific, Medtronic, and SMT. M. Swaans reports receiving consulting fees from -BioVentrix, Inc., and speakers fees from Abbott Vascular, Edwards -Lifesciences, and Philips Healthcare. G. Tang reports receiving consulting and speaker fees from Abbott Structural Heart and Medtronic. M. Taramasso repors receiving consultant fees from Abbott, Edwards Lifesciences, Shenqi Medical, Boston Scientific, 4tech, CoreMedic, Simulands, MTEx, and Occlufit, and speaker fees from Abbott, and Edwards Lifesciences. D. Tchétché reports receiving consulting fees Abbott, Boston, Edwards, and Medtronic. H. Thiele has no conflicts of interest to declare. Y. Topilsky reports receiving consulting fees from Edwards, and MitralTech, and speaker fees from Edwards, and Abbott. H. Treede has received research support from Abbott Vascular, Boston -Scientific, Edwards Lifesciences, JenaValve Technology, Medtronic, Tricares and -Abiomed. A. Vahanian reports consultancy for -CardioValve, and receiving consulting fees from Abbott Vascular, Edwards -Lifescience, and Medtronic. N. van Mieghem has received grants and personal fees from Abbott Vascular, Medtronic, Boston -Scientific, and PulseCath BV. K. Vitanova reports receiving speakers honoraria from Medtronic. S. Windecker reports receiving research and educational grants to the institution from Abbott, Amgen, BMS, Bayer, Boston Scientific, Biotronik, Cardinal Health, CSL Behring, Daiichi Sankyo, Edwards -Lifesciences, Johnson&Johnson, Medtronic, Querbet, Polares, Sanofi, Terumo, and Sinomed. N. Wunderlich reports receiving consulting fees from Edwards Lifesciences, Holitstick Medical and Cardiac Implants, and speaker fees from Cardiac Dimension, GE, Philipps, Gore, Abbott, Edwards Lifesciences, Occlutech, and Alnylam. M. Zuber has received fees from Edwards Lifesciences, and Abbott.
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