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Transcatheter Treatment of Functional Tricuspid Regurgitation Using the Trialign Device

机译:使用Trialign装置经导管治疗功能性三尖瓣关闭不全

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摘要

Functional tricuspid regurgitation (TR) represents an important unmet need in clinical cardiology given its prevalence, adverse prognostic impact and symptom burden associated with progressive right heart failure. Several transcatheter techniques are currently in early clinical testing to provide alternative treatment options for patients deemed unsuitable for tricuspid valve surgery. Amongst them, the TrialignTM device (Mitralign, Inc.) represents a novel percutaneous tricuspid valve annuloplasty technique, which aims to reduce tricuspid annular dilatation in functional TR by delivering and cinching two pledgeted sutures to the posterior portion of the tricuspid annulus via transjugular access. Early clinical data suggest the Trialign technique is safe and feasible, and associated with an improvement in quality-of-life measures. However, further studies are needed to confirm these data in larger cohorts of patients with longer follow up. In addition, future trials need to address the question whether TR reduction with the Trialign and other devices leads to an improvement in the patient`s functional status and prognosis, over and above medical treatment alone.
机译:鉴于功能性三尖瓣关闭不全(TR)的患病率,不良预后影响和与进行性右心衰竭相关的症状负担,代表了临床心脏病学中一项重要的未满足需求。目前有几种经导管技术正在早期临床测试中,以为认为不适合三尖瓣手术的患者提供替代治疗选择。其中,TrialignTM装置(Mitralign,Inc.)代表了一种新颖的经皮三尖瓣瓣环成形术技术,旨在通过经颈静脉入路将三张缝合的缝线输送并缝合到三尖瓣环的后部,从而减少功能性TR中的三尖瓣环扩张。早期的临床数据表明,Trialign技术是安全可行的,并且可以改善生活质量。但是,还需要进一步的研究来证实更多随访较长患者的数据。此外,未来的试验需要解决的问题是,仅通过药物治疗,使用Trialign和其他设备降低TR是否会改善患者的功能状态和预后。

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