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Right ventricle dysfunction assessment for transcatheter tricuspid valve repair: A matter of debate
European Journal of Clinical Investigation ( IF 5.5 ) Pub Date : 2021-07-22 , DOI: 10.1111/eci.13653
Alberto Preda 1 , Francesco Melillo 1 , Luca Liberale 2, 3 , Fabrizio Montecucco 1, 4 , Eustachio Agricola 1, 5
Affiliation  

Newer approaches in transcatheter tricuspid valve replacement (TTVR) have recently showed optimistic data of efficacy and safety in patients at high risk for surgery. However, the absence of residual regurgitation (and subsequently higher likelihood for developing afterload mismatch) with TTVR compared with transcatheter tricuspid valve intervention may become a critical concern if RV dysfunction is misdiagnosed. Indeed, such sudden increase in afterload on the right ventricle (RV) may not be tolerable, resulting in higher risk of acute right heart failure in the early postoperative period. In this context, strain imaging may find a further application to provide a more comprehensive stratification of the severity of RV dysfunction and thus help to better define the eligibility criteria and timing for TTVR. Meanwhile, it is of paramount importance to underline the contribution given by the Trivalve study on the understanding of the role of RV function in TTVI, that so far was largely undefined, being evaluated only in small noncontrolled cohorts.

中文翻译:

经导管三尖瓣修复的右心室功能障碍评估:一个有争议的问题

经导管三尖瓣置换术 (TTVR) 的较新方法最近显示了手术高风险患者的疗效和安全性的乐观数据。然而,如果 RV 功能障碍被误诊,与经导管三尖瓣干预相比,TTVR 没有残余反流(以及随后发生后负荷不匹配的可能性更高)可能成为一个关键问题。事实上,右心室 (RV) 后负荷的这种突然增加可能是无法忍受的,从而导致术后早期急性右心衰竭的风险更高。在这种情况下,应变成像可能会找到进一步的应用,以提供更全面的 RV 功能障碍严重程度分层,从而有助于更好地确定 TTVR 的资格标准和时机。同时,
更新日期:2021-07-22
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