Heterotopic Crosscaval Transcatheter Tricuspid Valve Replacement for Patients With Tricuspid Regurgitation

作者：Philipp Lurz, Karl‐Patrik Kresoja, Christian Besler, Stefan Verheye, Paul H.M.J. Vermeersch, Volker Rudolph, Kai Peter Friedrichs, Omar Abdul‐Jawad Altisent, Xavier Freixa, Laura Palomo Sanchís, Ignacio Cruz‐González, Pablo Antúnez‐Muiños, Jozef Bartunek, Marc Vanderheyden, Mohammad Sherif, Tobias Daniel Trippel, Rodrigo Estévez‐Loureiro, Manuel Barreiro‐Pérez, Hana Vaknin Assa, Ran Kornowski · 发表于：JACC: Cardiovascular Interventions · 年份：2025 · DOI：10.1016/j.jcin.2025.04.036 · 被引用次数：8 · 研究领域：Cardiac Valve Diseases and Treatments、Aortic Disease and Treatment Approaches、Pulmonary Hypertension Research and Treatments

BACKGROUND: Transcatheter tricuspid interventions are an emerging therapy for patients with severe tricuspid regurgitation (TR), but a significant proportion of patients with TR are unsuitable for orthotopic tricuspid valve (TV) approaches. OBJECTIVES: The aim of this study was to investigate the performance of a dedicated heterotopic valve replacement system in patients with severe or greater TR. METHODS: This single-arm, multicenter study assessed the technical performance, efficacy, and safety of heterotopic cross-caval transcatheter TV replacement using the Trillium device at 30 days. Patients with severe or greater TR ineligible for surgical or other interventional orthotopic TV treatment were included. RESULTS: Between 2021 and 2023, 20 patients (median age 81 years, 40% women) were included. Device implantation was successful in all cases, and no intraprocedural deaths or conversions to surgery occurred. Postprocedurally, central venous pressure was reduced (median -3 mm Hg; Q1-Q3: -5 to -1 mm Hg; P = 0.003), and TR severity as assessed at the level of the Trillium device was reduced in all cases (P < 0.001). Within the 30-day follow-up period, 1 patient died, 2 patients experienced heart failure hospitalization, 2 required hemodialysis, and 2 experienced major bleeding. There was an improvement in NYHA functional class (P = 0.005) and a trend toward a reduction in edema severity score (median -0.5; Q1-Q3: -1 to -0; P = 0.052). CONCLUSIONS: The Trillium device is a saf...