CAO Jingyi 1 , NING Xiaoping 1 , LI Ning 2 , QIAO Fan 1 , YANG Fan 1 , LI Bailing 1 , ZHOU Guangwei 1 , HAN Lin 1 , XU Zhiyun 1 , LU Fanglin 1,3
  • 1. Department of Cardiovascular Surgery, Changhai Hospital, Naval Medical University, Shanghai, 200433, P. R. China;
  • 2. Department of Cardiothoracic Surgery, Naval Medical Center of PLA, Naval Medical University, Shanghai, 200052, P. R. China;
  • 3. Department of Cardiovascular Surgery, Shanghai General Hospital, Shanghai Jiao Tong University, Shanghai, 200080, P. R. China;
LU Fanglin, Email: drlufanglin@yeah.net
Transcatheter tricuspid valve replacement; cardiac implantable electronic device; tricuspid regurgitation; clinical efficacy; multi-center retrospective cohort study
10.7507/1007-4848.202312041
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Objective To analyze the clinical efficacy of transcatheter tricuspid valve replacement (TTVR) in cardiac implantable electronic lead-related tricuspid regurgitation (TR). Methods The patients with severe TR who underwent LuX-Valve TTVR in 9 Chinese medical centers from June 2020 to August 2021 were retrospectively enrolled. They were divided into a cardiac implantable electronic device (CIED) group and a non-CIED group based on whether they had pre-existing CIED implantation. Success of the procedure was defined as safe implantation of the LuX-Valve and complete withdrawal of the delivery system. Prognostic improvement was defined as a decrease of TR grade to≤2+ and an improvement of cardiac function by≥2 grades. Surgical success and postoperative prognosis were compared between the two groups. Results A total of 190 patients were collected, including 50 males and 140 females with a mean age of 66.2±7.8 years. There were 29 patients in the CIED group, and 161 patients in the non-CIED group. In the CIED group, 28 patients were implanted with a permanent pacemaker and 1 patient with a cardioverter-defibrillator. Preoperative New York Heart Association (NYHA) cardiac function class, TR degree, left ventricular ejection fraction, tricuspid annular plane systolic excusion, and cardiac risk scores were comparable between the two groups (P>0.05). Postoperative TR was reduced to≤2+ in all patients, and there was no statistical difference in the incidence of perivalvular leakage between the two groups (P=0.270). Postoperative CT of CIED patients showed the valve was in place, and the lead was not extruded, twisted, or deflected. The in-hospital mortality of the two groups were 10.3% and 1.9%, respectively, and the difference was statistically significant (P=0.047). In addition, there was no statistical difference between the two groups in terms of postoperative improvement of cardiac function and mortality in the 1- and 2-year follow-up. Conclusion TTVR is feasible, safe, and effective in patients with CIED implantation, and the pre-existing lead has no significant effect on the clinical efficacy.