■经导管三尖瓣置换术(TTVR)最近成为治疗严重三尖瓣返流(TR)的一种新的治疗方法。然而,手术三尖瓣置换术(STVR)仍然是主要的治疗方式。关于这两种程序的比较数据有限。这项研究旨在比较接受小切口经心房LuX瓣膜TTVR的患者和接受STVR的患者之间的临床和超声心动图结果。
■本研究前瞻性收集了2019年至2022年在武汉协和医院接受TTVR(n=29)或孤立STVR(n=59)的重度TR患者。所有TTVR患者均通过小切口和经心房入路接受了LuX瓣膜。比较30天和1年随访时的临床和超声心动图结果。
■在基线时,与STVR相比,接受LuX-ValveTTVR的患者具有更高的手术风险评分和更高的右心室功能障碍比例.在术后早期,STVR组右心室功能下降幅度更大.住院时间(LOS)重症监护室LOS,总手术时间,TTVR组气管插管时间短于STVR组。在接受TTVR的患者中,术后瓣膜旁漏的发生率较高。与STVR组相比,TTVR组的起搏器植入率较低.随访期间,TTVR组的三尖瓣峰值速度和平均梯度始终低于STVR组.在30天和一年的随访中,TTVR和STVR的死亡率相似。
■经心房的微型开胸手术LuX瓣膜TTVR比STVR具有更高的瓣周漏发生率和更低的起搏器植入率,30天和1年死亡率相似。在某些方面,小切口经心房LuX瓣膜TTVR可能是特定人群可行和安全的治疗选择,或者它可能作为补充常规STVR的替代疗法。需要进一步随访以评估长期临床结果和瓣膜耐久性的差异。
UNASSIGNED: Transcatheter tricuspid valve replacement (TTVR) has recently emerged as a novel therapeutic approach for managing severe tricuspid regurgitation (TR). However, surgical tricuspid valve replacement (STVR) continues to be the predominant treatment modality. There are limited comparative data on both procedures. This study aimed to compare clinical and echocardiographic outcomes between patients who underwent mini-thoracotomy transatrial LuX-Valve TTVR and those who underwent STVR.
UNASSIGNED: This study prospectively collected patients with severe TR who underwent TTVR (n = 29) or isolated STVR (n = 59) at Wuhan Union Hospital from 2019 to 2022. All TTVR patients received the LuX-Valve via a mini-thoracotomy and transatrial approach. The clinical and echocardiographic outcomes were compared at 30-day and one-year follow-ups.
UNASSIGNED: At baseline, patients with LuX-Valve TTVR had higher surgical risk scores and a greater proportion of right ventricular dysfunction compared with STVR. In the early postoperative period, the STVR group had a greater decrease in right ventricular function. Hospital length of stay (LOS), intensive care unit LOS, total procedure time, and tracheal intubation time were shorter in the TTVR than in the STVR group. The incidence of postoperative paravalvular leaks was higher among patients who underwent TTVR. Compared to the STVR group, the pacemaker implantation rate was lower in the TTVR group. During follow-up, the peak tricuspid valve velocity and mean gradient in the TTVR group were consistently lower than those in the STVR group. There was similar mortality between TTVR and STVR at 30-day and one-year follow-ups.
UNASSIGNED: The mini-thoracotomy transatria LuX-Valve TTVR has a higher incidence of paravalvular leaks and a lower rate of pacemaker implantation than STVR, with similar 30-day and one-year mortality rates. In some respects, mini-thoracotomy transatrial LuX-Valve TTVR may be a feasible and safe treatment option for specific populations, or it could potentially serve as an alternative therapy to supplement conventional STVR. Further follow-up is required to assess differences in long-term clinical outcomes and valve durability.