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Impact of Leaflet-to-Annulus Index on Residual Regurgitation Following Transcatheter Edge-to-Edge Repair of the Tricuspid Valve.
Pizzino, Fausto; Trimarchi, Giancarlo; D'Agostino, Andreina; Bonanni, Michela; Benedetti, Giovanni; Paradossi, Umberto; Manzo, Rachele; Capasso, Rosangela; Di Bella, Gianluca; Zito, Concetta; Carerj, Scipione; Berti, Sergio; Mariani, Massimiliano.
Afiliación
  • Pizzino F; Fondazione Toscana G. Monasterio, Ospedale del Cuore, 54100 Massa, Italy.
  • Trimarchi G; Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy.
  • D'Agostino A; Fondazione Toscana G. Monasterio, Ospedale del Cuore, 54100 Massa, Italy.
  • Bonanni M; Fondazione Toscana G. Monasterio, Ospedale del Cuore, 54100 Massa, Italy.
  • Benedetti G; Fondazione Toscana G. Monasterio, Ospedale del Cuore, 54100 Massa, Italy.
  • Paradossi U; Fondazione Toscana G. Monasterio, Ospedale del Cuore, 54100 Massa, Italy.
  • Manzo R; Department of Advanced Biomedical Sciences, Division of Cardiology, Federico II University, 80131 Naples, Italy.
  • Capasso R; Department of Clinical and Molecular Medicine, Division of Cardiology, Sapienza University of Rome, 00185 Rome, Italy.
  • Di Bella G; Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy.
  • Zito C; Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy.
  • Carerj S; Department of Clinical and Experimental Medicine, University of Messina, 98100 Messina, Italy.
  • Berti S; Fondazione Toscana G. Monasterio, Ospedale del Cuore, 54100 Massa, Italy.
  • Mariani M; Fondazione Toscana G. Monasterio, Ospedale del Cuore, 54100 Massa, Italy.
J Clin Med ; 13(14)2024 Jul 17.
Article en En | MEDLINE | ID: mdl-39064216
ABSTRACT

Background:

The mismatch between tricuspid valve (TV) leaflet length and annulus dilation, assessed with the septal-lateral leaflet-to-annulus index (SL-LAI), predicts residual tricuspid regurgitation (TR) following tricuspid transcatheter edge-to-edge-repair (T-TEER). When posterior leaflet grasping is required, the anterior-posterior leaflet-to-annulus index (AP-LAI) may offer additional information.

Methods:

This single-center retrospective cohort study included all patients referred for T-TEER with severe and symptomatic TR with high surgical risk from April 2021 to March 2024. Patients were categorized into 'optimal result' (transesophageal echocardiography (TEE) measurements.

Results:

Of the 25 patients, 12 had suboptimal post-procedural results, while 13 showed optimal outcomes. The optimal result group showed a higher prevalence of type IIIA-IIIB TV morphology (85% vs. 45%, p < 0.05), a wider SL annulus diameter (42.5 ± 5 vs. 37 ± 5 mm, p < 0.05), and a longer posterior leaflet length (28 ± 4 vs. 22 ± 5 mm, p < 0.01). The SL-LAI was lower in the optimal group (1 ± 0.2 vs. 1.2 ± 0.32, p < 0.05), while the AP-LAI was higher (0.7 ± 0.1 vs. 0.5 ± 0.2, p < 0.05). ROC curve analysis showed that the AUC for the AP-LAI was 0.769 (95% CI 0.51-0.93, p < 0.05) and Youden test identified the best cut-off value <0.5 (sensitivity 50% and specificity 100%) for a suboptimal result. The SL-LAI showed a very low AUC in predicting suboptimal results (0.245, 95% CI 0.08-0.47). Comparing the two ROC curves, we showed that AUC difference is significant with the AP-LAI showing the best association with the outcome (p = 0.01).

Conclusions:

The AP-LAI and SL-LAI can help in predicting post T-TEER results, ameliorating patients' outcomes and avoiding futile procedures.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Italia Pais de publicación: Suiza