Concomitant Transcatheter Edge-to-Edge Treatment of Secondary Tricuspid and Mitral Regurgitation: An Expert Opinion

Antonio Sisinni; Maurizio Taramasso; Fabien Praz; Marco Metra; Eustachio Agricola; Alberto Margonato; Neil Fam; Rodrigo Estevez-Loureiro; Azeem Latib; David Messika-Zeitoun; Lenard Conradi; Ralph Stephan von Bardeleben; Paul Sorajja; Rebecca T Hahn; Sergio Caravita; Francesco Maisano; Marianna Adamo; Cosmo Godino

doi:10.1016/j.jcin.2022.11.022

Concomitant Transcatheter Edge-to-Edge Treatment of Secondary Tricuspid and Mitral Regurgitation: An Expert Opinion

JACC Cardiovasc Interv. 2023 Jan 23;16(2):127-139. doi: 10.1016/j.jcin.2022.11.022.

Authors

Antonio Sisinni¹, Maurizio Taramasso², Fabien Praz³, Marco Metra⁴, Eustachio Agricola⁵, Alberto Margonato⁶, Neil Fam⁷, Rodrigo Estevez-Loureiro⁸, Azeem Latib⁹, David Messika-Zeitoun¹⁰, Lenard Conradi¹¹, Ralph Stephan von Bardeleben¹², Paul Sorajja¹³, Rebecca T Hahn¹⁴, Sergio Caravita¹⁵, Francesco Maisano⁶, Marianna Adamo¹⁶, Cosmo Godino¹⁷

Affiliations

¹ Cardiology Unit, IRCCS Policlinico San Donato, Milan, Italy; Università degli studi di Milano, Milan, Italy. Electronic address: https://twitter.com/antosis_93.
² Division of Cardiac Surgery, Herzklinik Hirslanden, Zürich, Switzerland.
³ Department of Cardiology, University Hospital Bern, Bern, Switzerland.
⁴ Cardiology Unit, Cardiothoracic Department, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Spedali Civili of Brescia, University of Brescia, Brescia, Italy.
⁵ Cardiovascular Imaging Unit, Cardio-Thoracic- Vascular Department, IRCCS San Raffaele Scientific Institute and Vita-Salute University, Milan, Italy.
⁶ Heart Valve Center, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele Scientific Institute and Vita-Salute University, Milan, Italy.
⁷ Division of Cardiology, St. Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
⁸ Cardiology Department, University Hospital Alvaro Cunqueiro, Galicia Sur Health Research Institute, Vigo, Spain.
⁹ Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, USA.
¹⁰ Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
¹¹ Department of Cardiovascular Surgery, University Heart and Vascular Center Hamburg, Hamburg, Germany.
¹² Zentrum für Kardiologie, Johannes Gutenberg-Universität, Mainz, Germany.
¹³ Department of Cardiology, Allina Health Minneapolis Heart Institute at Abbott Northwestern Hospital, Minneapolis, Minnesota, USA.
¹⁴ NewYork-Presbyterian Hospital, Columbia University Medical Center, New York, New York, USA.
¹⁵ Dyspnea and Pulmonary Hypertension Center, Department of Cardiology, Istituto Auxologico Italiano IRCCS, Ospedale San Luca, Milan, Italy; Department of Management, Information and Production Engineering, University of Bergamo, Dalmine, Italy.
¹⁶ Cardiac Catheterization Laboratory and Cardiology Unit, Cardiothoracic Department, Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, Spedali Civili of Brescia, University of Brescia, Brescia, Italy.
¹⁷ Heart Valve Center, Cardio-Thoracic-Vascular Department, IRCCS San Raffaele Scientific Institute and Vita-Salute University, Milan, Italy. Electronic address: cosmogodino@gmail.com.

PMID: 36697147
DOI: 10.1016/j.jcin.2022.11.022

Abstract

Secondary (functional) tricuspid regurgitation (sTR) is common in patients with mitral regurgitation (MR). Because combined valvular heart disease affects long-term survival, in comparison with isolated MR or tricuspid regurgitation, it is essential to offer patients adequate treatment. Despite considerable experience, no conclusive data are yet available on the prognostic impact of concomitant tricuspid valve surgery at the time of mitral valve surgery. Emerging transcatheter treatments offer the opportunity to treat both conditions (MR and sTR) simultaneously or in a stepwise fashion. This review provides a clinical overview on available data regarding the rationale for treatment of sTR in patients with relevant MR undergoing mitral transcatheter edge-to-edge repair, focusing on clinical and anatomical selection criteria.

Keywords: concomitant treatment; mitral regurgitation; secondary tricuspid regurgitation; transcatheter mitral valve repair; tricuspid transcatheter edge-to-edge repair.

Publication types

Review

MeSH terms

Cardiac Catheterization / adverse effects
Expert Testimony
Heart Valve Prosthesis Implantation* / adverse effects
Humans
Mitral Valve / diagnostic imaging
Mitral Valve / surgery
Mitral Valve Insufficiency* / diagnostic imaging
Mitral Valve Insufficiency* / surgery
Treatment Outcome
Tricuspid Valve Insufficiency* / diagnostic imaging
Tricuspid Valve Insufficiency* / surgery