1Immanuel Klinikum Bernau Herzzentrum Brandenburg / Kardiologie Bernau bei Berlin, Deutschland; 2Universitätsklinikum Ruppin-Brandenburg Humanmedizin Neuruppin, Deutschland
Background Patients with right cardiac decompensation due to massive tricuspid regurgitation (TR) are not always suitable for tricuspid edge to edge repair. In these cases, patients are screened for alternative treatment methods, especially heterotopic minimally invasive tricuspid repair with the Tricento system or the TricValve system. Both systems use a neovalve system covering the vena cava superior and vena cava inferior to reduce und prevent symptoms of TR and retrograde congestion. To date, it is unclear at what point the treatment of severe TR can no longer prolong survival and which patients benefit most from the treatment.
Methods Retrospective cohort study analyzing demographics, comorbidities and outcome data in patients receiving a Tricento prothesis or a TricValve prothesis. The primary endpoint was defined as mortality.
Results From June 2019 to October 2023, 20 patients with severe TR received minimally invasive heterotopic transfemoral tricuspid valve repair, 5 patients with the Tricento system and 15 patients with the TricValve system. Twelve patients (60%) were female, mean age was 79.1 years (SD 6.9). Mean follow up time was 15.2 months (SD 13.4). 35% of patients (7/20) died within a mean survival time of 6.8 months. Patients meeting the endpoint were more often male (p.03), more frequently presented with ascites (p.005), renal impairment (p.03) and higher NT-proBNP concentrations (p.001) compared to those who survived follow-up time. There were no differences in echocardiographic data between patients with clinical benefit and those who died (Table 1).
Conclusion Patients receiving a heterotopic transfemoral minimally invasive tricuspid valve repair have multiple comorbidities. Patients with ascites, high NT-proBNP concentrations and renal impairment are at a higher risk for shorter survival.