Transcatheter Tricuspid Interventions: Past, Present, and Future
Tricuspid regurgitation (TR) etiologies include primary valve pathology or secondary (functional) regurgitation from increased hemodynamic pressure or volume on the right side of the heart. Patients with severe TR have a worse prognosis independent of all other variables. Surgical treatment for TR h...
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| Published in: | Methodist DeBakey cardiovascular journal Vol. 19; no. 3; pp. 57 - 66 |
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| Main Authors: | , |
| Format: | Journal Article |
| Language: | English |
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United States
Ubiquity Press Ltd
16.05.2023
Houston Methodist DeBakey Heart & Vascular Center |
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| ISSN: | 1947-6108, 1947-6094, 1947-6108 |
| Online Access: | Get full text |
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| Abstract | Tricuspid regurgitation (TR) etiologies include primary valve pathology or secondary (functional) regurgitation from increased hemodynamic pressure or volume on the right side of the heart. Patients with severe TR have a worse prognosis independent of all other variables. Surgical treatment for TR has mostly been limited to patients undergoing concomitant left-sided cardiac surgery. The results and durability of surgical repair or replacement are not well defined. For patients with significant and symptomatic TR, transcatheter techniques would be beneficial, but these techniques and devices have been slow to develop. Much of the delay is a result of neglect and challenges in defining the symptoms associated with TR. In addition, the anatomic and physiological aspects of the tricuspid valve apparatus present unique challenges. Several devices and techniques are in various phases of clinical investigation. This review highlights the current landscape of transcatheter tricuspid interventions and future opportunities. It is imminent that these therapies become commercially available and widely adopted to have a significant positive impact on millions of patients that have been neglected. |
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| AbstractList | Tricuspid regurgitation (TR) etiologies include primary valve pathology or secondary (functional) regurgitation from increased hemodynamic pressure or volume on the right side of the heart. Patients with severe TR have a worse prognosis independent of all other variables. Surgical treatment for TR has mostly been limited to patients undergoing concomitant left-sided cardiac surgery. The results and durability of surgical repair or replacement are not well defined. For patients with significant and symptomatic TR, transcatheter techniques would be beneficial, but these techniques and devices have been slow to develop. Much of the delay is a result of neglect and challenges in defining the symptoms associated with TR. In addition, the anatomic and physiological aspects of the tricuspid valve apparatus present unique challenges. Several devices and techniques are in various phases of clinical investigation. This review highlights the current landscape of transcatheter tricuspid interventions and future opportunities. It is imminent that these therapies become commercially available and widely adopted to have a significant positive impact on millions of patients that have been neglected. Tricuspid regurgitation (TR) etiologies include primary valve pathology or secondary (functional) regurgitation from increased hemodynamic pressure or volume on the right side of the heart. Patients with severe TR have a worse prognosis independent of all other variables. Surgical treatment for TR has mostly been limited to patients undergoing concomitant left-sided cardiac surgery. The results and durability of surgical repair or replacement are not well defined. For patients with significant and symptomatic TR, transcatheter techniques would be beneficial, but these techniques and devices have been slow to develop. Much of the delay is a result of neglect and challenges in defining the symptoms associated with TR. In addition, the anatomic and physiological aspects of the tricuspid valve apparatus present unique challenges. Several devices and techniques are in various phases of clinical investigation. This review highlights the current landscape of transcatheter tricuspid interventions and future opportunities. It is imminent that these therapies become commercially available and widely adopted to have a significant positive impact on millions of patients that have been neglected.Tricuspid regurgitation (TR) etiologies include primary valve pathology or secondary (functional) regurgitation from increased hemodynamic pressure or volume on the right side of the heart. Patients with severe TR have a worse prognosis independent of all other variables. Surgical treatment for TR has mostly been limited to patients undergoing concomitant left-sided cardiac surgery. The results and durability of surgical repair or replacement are not well defined. For patients with significant and symptomatic TR, transcatheter techniques would be beneficial, but these techniques and devices have been slow to develop. Much of the delay is a result of neglect and challenges in defining the symptoms associated with TR. In addition, the anatomic and physiological aspects of the tricuspid valve apparatus present unique challenges. Several devices and techniques are in various phases of clinical investigation. This review highlights the current landscape of transcatheter tricuspid interventions and future opportunities. It is imminent that these therapies become commercially available and widely adopted to have a significant positive impact on millions of patients that have been neglected. Tricuspid regurgitation (TR) etiologies include primary valve pathology or secondary (functional) regurgitation from increased hemodynamic pressure or volume on the right side of the heart. Patients with severe TR have a worse prognosis independent of all other variables. Surgical treatment for TR has mostly been limited to patients undergoing concomitant left-sided cardiac surgery. The results and durability of surgical repair or replacement are not well defined. For patients with significant and symptomatic TR, transcatheter techniques would be beneficial, but these techniques and devices have been slow to develop. Much of the delay is a result of neglect and challenges in defining the symptoms associated with TR. In addition, the anatomic and physiological aspects of the tricuspid valve apparatus present unique challenges. Several devices and techniques are in various phases of clinical investigation. This review highlights the current landscape of transcatheter tricuspid interventions and future opportunities. It is imminent that these therapies become commercially available and widely adopted to have a significant positive impact on millions of patients that have been neglected. Keywords: tricuspid regurgitation, tricuspid valve: transcatheter tricuspid valve repair, TTVR |
| Audience | Academic |
| Author | Barker, Colin M. Goel, Kashish |
| AuthorAffiliation | 1 Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, Tennessee, US |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/37213880$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1016/j.amjcard.2020.12.070 10.1016/j.jcin.2019.09.046 10.14797/mdcj-13-3-120 10.1016/j.jcin.2020.07.008 10.4244/EIJ-D-21-00695 10.1016/j.jcin.2022.05.022 10.14797/mdcj-15-2-149 10.1016/j.jcin.2022.06.023 10.2217/cer-2020-0198 10.1016/j.jcmg.2018.11.034 10.4244/EIJV12SYA32 10.2217/fca-2020-0181 10.1016/j.jcin.2022.07.006 10.1016/j.jcin.2022.01.016 10.1080/13696998.2020.1718681 10.1016/j.jcmg.2018.08.034 10.1016/j.jacc.2019.09.028 10.1016/j.jcin.2019.04.019 10.1016/j.jcmg.2018.09.027 10.1016/j.jcin.2020.08.020 10.1016/S0140-6736(19)32600-5 10.1111/echo.14327 10.1001/jama.2021.2133 10.1016/j.jacc.2020.11.047 10.1016/j.pcad.2019.11.004 10.1016/j.jcin.2020.03.026 |
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| Keywords | tricuspid regurgitation tricuspid valve: transcatheter tricuspid valve repair TTVR |
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| SubjectTerms | Cardiac Catheterization Heart Valve Prosthesis Implantation Humans Review Treatment Outcome tricuspid regurgitation Tricuspid Valve - diagnostic imaging Tricuspid Valve - surgery Tricuspid Valve Insufficiency - diagnostic imaging Tricuspid Valve Insufficiency - surgery tricuspid valve: transcatheter tricuspid valve repair ttvr |
| Title | Transcatheter Tricuspid Interventions: Past, Present, and Future |
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