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Review
. 2022 Sep 14:9:994502.
doi: 10.3389/fcvm.2022.994502. eCollection 2022.

Transcatheter tricuspid valve interventions: Current status and future perspectives

Alberto Alperi  1   2 , Marcel Almendárez  1   2 , Rut Álvarez  1   2 , Cesar Moris  1   2   3 , Victor Leon  1   2 , Iria Silva  1   2 , Daniel Hernández-Vaquero  1   2   3 , Isaac Pascual  1   2   3 , Pablo Avanzas  1   2   3
Affiliations
Review

Transcatheter tricuspid valve interventions: Current status and future perspectives

Alberto Alperi et al. Front Cardiovasc Med. .

Abstract

The development of transcatheter therapies to treat valvular heart diseases has changed the rules of the game, particularly in the case of aortic stenosis and mitral regurgitation. In the last years, the tricuspid valve has also been the focus of these percutaneous techniques for several reasons: (1) tricuspid regurgitation is a frequent disease associated with poor clinical outcomes in spite of medical treatment, leading to end-stage right ventricular heart failure, (2) surgical tricuspid valve repair or replacement has been the treatment of choice for patients with tricuspid valve disease, but high mortality rates for isolated surgical tricuspid valve intervention have been reported in the literature, and (3) most patients with tricuspid pathology are ultimately denied cardiac surgery because of their comorbidity burden. Thus, in this context the development of less invasive catheter-based therapies would be of high clinical relevance. The present review provides an overview regarding the framework of chronic tricuspid regurgitation transcatheter therapeutic options, summarizes the transcatheter systems under clinical use or clinical evaluation with their technical features, and describes the updated current evidence in this challenging and evolving field.

Keywords: transcatheter tricuspid valve repair; transcatheter tricuspid valve replacement; tricuspid incompetence; tricuspid regurgitation; valve heart disease.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
(A) CCT reconstruction for the assessment of tricuspid annular sizing before TTV annuloplasty repair or TTV replacement. Yellow circle represents tricuspid annular perimeter, blue double-headed arrow the anteroposterior diameter, and orange double-headed arrow the septo-lateral diameter. (B) CCT reconstruction assessing the distance between the tricuspid annulus and the right coronary artery. (C) Antero-posterior fluoroscopic view of the CCT-derived IVC-RA junction to mid-tricuspid annular distance. (D) Fluoroscopic right anterior oblique view demonstrating the angulation to be undertaken by the device delivery system. (E) CCT 3-dimensional reconstruction after Tric-valve implantation. (F) CCT coronal view after Tric-valve implantation.
Figure 2
Figure 2
TTV repair devices under clinical evaluation. (A) TriClip device with standard and long-length arm [reprinted from Wong et al. (25) with permission from the publisher]. (B) TriClip delivery system. (C) PASCAL device [reprinted from (14) with permission from the publisher]. (D) Cardioband device [reprinted from (26) with permission from the publisher]. (E) Trialign device [reprinted from (22) with permission from the publisher]. (F) Mistral device [reprinted from (27) with permission from the publisher].
Figure 3
Figure 3
TTV replacement devices under clinical evaluation. (A) Gate System; (B) Evoque Valve; (C) LuX-Valve; (D) Sapien XT valve; (E) TricValve; (F) Tricento system. Reprinted with permission from the publisher.
Figure 4
Figure 4
Overview of the several devices and their mechanism of action in the transcatheter tricuspid valve intervention field.
See this image and copyright information in PMC

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References

    1. Singh JP, Evans JC, Levy D, Larson MG, Freed LA, Fuller DL, et al. . Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study). Am J Cardiol. (1999) 83:897–902. 10.1016/S0002-9149(98)01064-9 - DOI - PubMed
    1. Asmarats L, Taramasso M, Rodés-Cabau J. Tricuspid valve disease: diagnosis, prognosis and management of a rapidly evolving field. Nat Rev Cardiol. (2019) 16:538–54. 10.1038/s41569-019-0186-1 - DOI - PubMed
    1. Chang JD, Manning WJ, Ebrille E, Zimetbaum PJ. Tricuspid valve dysfunction following pacemaker or cardioverter-defibrillator implantation. J Am Coll Cardiol. (2017) 69:2331–41. 10.1016/j.jacc.2017.02.055 - DOI - PubMed
    1. Ohno Y, Attizzani GF, Capodanno D, Cannata S, Dipasqua F, Immé S, et al. . Association of tricuspid regurgitation with clinical and echocardiographic outcomes after percutaneous mitral valve repair with the MitraClip System: 30-day and 12-month follow-up from the GRASP Registry. Eur Heart J Cardiovasc Imaging. (2014) 15:1246–55. 10.1093/ehjci/jeu114 - DOI - PubMed
    1. Pavasini R, Ruggerini S, Grapsa J, Biscaglia S, Tumscitz C, Serenelli M, et al. . Role of the tricuspid regurgitation after mitraclip and transcatheter aortic valve implantation: a systematic review and meta-Analysis. Eur Heart J Cardiovasc Imaging. (2018) 19:654–9. 10.1093/ehjci/jex143 - DOI - PubMed

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