PMID- 35662675 OWN - NLM STAT- MEDLINE DCOM- 20230501 LR - 20230501 IS - 1885-5857 (Electronic) IS - 1885-5857 (Linking) VI - 76 IP - 5 DP - 2023 May TI - Early and mid-term outcomes of transcatheter tricuspid valve repair: systematic review and meta-analysis of observational studies. PG - 322-332 LID - S1885-5857(22)00135-9 [pii] LID - 10.1016/j.rec.2022.06.004 [doi] AB - INTRODUCTION AND OBJECTIVES: Severe tricuspid regurgitation (TR) is associated with poor prognosis when left untreated, and a growing number of studies on transcatheter tricuspid valve repair (TTVr) have been published over the last few months. METHODS: We performed a comprehensive systematic review of published literature providing clinical data on TTVr for patients with significant TR. Early and mid-term clinical and echocardiographic outcomes were evaluated. Risk ratios (RR) or mean differences (MD) were obtained when comparing pre- and postprocedural data. A sensitivity analysis was also performed according to the main approach for repair (edge-to-edge vs annuloplasty). RESULTS: A total of 19 studies (all observational or single-arm trials) and 991 patients who underwent isolated TTVr were included. Thirty-day mortality and stroke rates were 2.8% and 0.2%, respectively. Pooled random-effects resulted in a significant reduction of >/= severe TR (RR, 0.33; 95%CI, 0.26-0.42; P < .001), vena contracta width (MD, 5.9mm; 95%CI, 4-7.9; P <.001), right ventricular end-diastolic diameter (MD, 3.5mm; 95%CI, 2.5-4.5; P <.001), and New York Heart Association (NYHA) class III or IV at last follow-up (RR, 0.32; 95%CI, 0.27-0.37; P <.001). Bleeding complications and residual >/= severe TR were numerically higher in the annuloplasty-like group compared with edge-to-edge repair (13.3% vs 3.8% for bleeding and 40.4% vs 27.9% for residual severe TR). CONCLUSIONS: Among 991 patients comprising the early experience for several TTVr devices, there was a statistically significant reduction in >/= severe TR, NYHA class III-IV, vena contracta width and right ventricular end-diastolic diameter after TTVr. Thus far, the edge-to-edge approach seems to be associated with a better safety profile. CI - Copyright (c) 2022 Sociedad Espanola de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved. FAU - Alperi, Alberto AU - Alperi A AD - Area del Corazon, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Instituto de Investigacion Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain. FAU - Avanzas, Pablo AU - Avanzas P AD - Area del Corazon, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Instituto de Investigacion Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Universidad de Oviedo, Oviedo, Spain. Electronic address: avanzas@secardiologia.es. FAU - Almendarez, Marcel AU - Almendarez M AD - Area del Corazon, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Instituto de Investigacion Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain. FAU - Leon, Victor AU - Leon V AD - Area del Corazon, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain. FAU - Hernandez-Vaquero, Daniel AU - Hernandez-Vaquero D AD - Area del Corazon, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Instituto de Investigacion Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Universidad de Oviedo, Oviedo, Spain. FAU - Silva, Iria AU - Silva I AD - Area del Corazon, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain. FAU - Fernandez Del Valle, David AU - Fernandez Del Valle D AD - Area del Corazon, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain. FAU - Fernandez, Felix AU - Fernandez F AD - Area del Corazon, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain. FAU - Diaz, Rocio AU - Diaz R AD - Area del Corazon, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Instituto de Investigacion Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain. FAU - Rodes-Cabau, Josep AU - Rodes-Cabau J AD - Quebecs Heart and Lung Institute, Quebec, Canada. FAU - Moris, Cesar AU - Moris C AD - Area del Corazon, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Instituto de Investigacion Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Universidad de Oviedo, Oviedo, Spain. FAU - Pascual, Isaac AU - Pascual I AD - Area del Corazon, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain; Instituto de Investigacion Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain; Universidad de Oviedo, Oviedo, Spain. LA - eng LA - spa PT - Journal Article PT - Meta-Analysis PT - Systematic Review DEP - 20220602 PL - Spain TA - Rev Esp Cardiol (Engl Ed) JT - Revista espanola de cardiologia (English ed.) JID - 101587954 SB - IM MH - Humans MH - Tricuspid Valve/diagnostic imaging/surgery MH - *Heart Valve Prosthesis Implantation/methods MH - Treatment Outcome MH - Cardiac Catheterization/methods MH - *Tricuspid Valve Insufficiency/diagnosis/surgery OTO - NOTNLM OT - Incompetencia tricuspidea OT - Insuficiencia valvular tricuspidea OT - Intervencion transcateter de la valvula tricuspide OT - Regurgitacion tricuspidea OT - Reparacion tricuspidea transcateter OT - Transcatheter tricuspid valve intervention OT - Transcatheter tricuspid valve repair OT - Tricuspid incompetence OT - Tricuspid regurgitation OT - tricuspid valve insufficiency EDAT- 2022/06/07 06:00 MHDA- 2023/05/01 06:42 CRDT- 2022/06/06 13:43 PHST- 2022/03/18 00:00 [received] PHST- 2022/05/23 00:00 [accepted] PHST- 2023/05/01 06:42 [medline] PHST- 2022/06/07 06:00 [pubmed] PHST- 2022/06/06 13:43 [entrez] AID - S1885-5857(22)00135-9 [pii] AID - 10.1016/j.rec.2022.06.004 [doi] PST - ppublish SO - Rev Esp Cardiol (Engl Ed). 2023 May;76(5):322-332. doi: 10.1016/j.rec.2022.06.004. Epub 2022 Jun 2.