Early Feasibility Study of Cardioband Tricuspid System for Functional Tricuspid Regurgitation 30-Day Outcomes

被引:56
|
作者
Davidson, Charles J. [1 ]
Lim, D. Scott [2 ]
Smith, Robert L. [3 ]
Kodali, Susheel K. [4 ]
Kipperman, Robert M. [5 ]
Eleid, Mackram F. [6 ]
Reisman, Mark [7 ]
Whisenant, Brian [8 ]
Puthumana, Jyothy [1 ]
Abramson, Sandra [9 ]
Fowler, Dale [2 ]
Grayburn, Paul [3 ]
Hahn, Rebecca T. [4 ]
Koulogiannis, Konstantinos [5 ]
Pislaru, Sorin, V [6 ]
Zwink, Todd [7 ]
Minder, Michael [8 ]
Dahou, Abdellaziz [10 ]
Deo, Shekhar H. [11 ]
Vandrangi, Prashanthi [11 ]
Deuschl, Florian [11 ]
Feldman, Ted E. [11 ]
Gray, William A. [9 ]
机构
[1] Northwestern Univ, Dept Med, Feinberg Sch Med, Chicago, IL 60611 USA
[2] Univ Virginia Hlth Syst Hosp, Dept Med, Charlottesville, VA USA
[3] Heart Hosp Baylor, Dept Cardiothorac Surg, Plano, TX USA
[4] Columbia Univ, Dept Med, Med Ctr, New York, NY USA
[5] Morristown Med Ctr, Dept Cardiovasc Surg, Morristown, NJ USA
[6] Mayo Clin, Dept Cardiovasc Med, Rochester, MN USA
[7] Univ Washington, Dept Med, Seattle, WA USA
[8] Intermt Healthcare, Div Cardiovasc Dis, Salt Lake City, UT USA
[9] Lankenau Med Ctr, Div Cardiol, Main Line Hlth, Wynnewood, PA USA
[10] Cardiovasc Res Fdn, New York, NY USA
[11] Edwards Lifesci, Irvine, CA USA
关键词
Cardioband; reconstruction; tricuspid; NATIVE VALVULAR REGURGITATION; EUROPEAN ASSOCIATION; AMERICAN SOCIETY; VALVE SURGERY; ECHOCARDIOGRAPHY; RECOMMENDATIONS; REPAIR;
D O I
10.1016/j.jcin.2020.10.017
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
OBJECTIVES The study reports for the first time the 30-day outcomes of the first U.S. study with the Cardioband tricuspid valve reconstruction system for the treatment of functional tricuspid regurgitation (TR). BACKGROUND Increasing severity of TR is associated with progressively higher morbidity and mortality; however, treatment options for isolated significant disease are limited. METHODS In this single-arm, multicenter, prospective Food and Drug Administration-approved early feasibility study (EFS), 30 patients with severe or greater symptomatic functional TR were enrolled who were deemed candidates for transcatheter tricuspid repair with the Cardioband tricuspid system by the local heart team and multidisciplinary screening committee. RESULTS The mean patient age was 77 years, 80% were women, 97% had atrial fibrillation, 70% were in New York Heart Association functional class III to IV with mean left ventricular ejection fraction of 58%, and 27% had severe, 20% massive, and 53% torrential TR. Device success was 93% and all patients were alive at 30 days. Between baseline and 30 days, septolateral tricuspid annular diameter was reduced by 13% (p < 0.001), 85% of patients had >= 1 grade TR reduction and 44% had <= moderate TR, 75% were in New York Heart Association functional class I to II (p < 0.001), and overall Kansas City Cardiomyopathy Questionnaire score improved by 16 points (p < 0.001). CONCLUSIONS In patients with severe symptomatic functional TR, this is the first study in the United States with the Cardioband tricuspid system for direct transcatheter annular reduction. This early feasibility study demonstrates high procedural feasibility with no 30-day mortality. There is significant reduction of functional TR with clinically significant improvements in functional status and quality of life. (C) 2021 by the American College of Cardiology Foundation.
引用
收藏
页码:41 / 50
页数:10
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