First-in-human transcatheter pledget-assisted suture tricuspid annuloplasty for severe tricuspid insufficiency.

MedStar author(s):
Citation: Catheterization & Cardiovascular Interventions. 97(1):E130-E134, 2021 01 01.PMID: 32385950Institution: MedStar Heart & Vascular InstituteForm of publication: Journal ArticleMedline article type(s): Journal ArticleSubject headings: *Cardiac Valve Annuloplasty | *Heart Valve Prosthesis Implantation | *Tricuspid Valve Insufficiency | Aged, 80 and over | Cardiac Valve Annuloplasty/ae [Adverse Effects] | Heart Valve Prosthesis Implantation/ae [Adverse Effects] | Humans | Male | Mitral Valve | Sutures | Treatment Outcome | Tricuspid Valve Insufficiency/dg [Diagnostic Imaging] | Tricuspid Valve Insufficiency/su [Surgery] | Tricuspid Valve/dg [Diagnostic Imaging] | Tricuspid Valve/su [Surgery]Year: 2021Local holdings: Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006ISSN:
  • 1522-1946
Name of journal: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & InterventionsAbstract: BACKGROUND: Tricuspid valve regurgitation is a common malignant disease with no commercially available transcatheter therapy. PASTA is a "percutaneous surgical" procedure using pledgeted sutures to create a double-orifice tricuspid valve.CONCLUSIONS: The anatomy of a double-orifice valve can eliminate TR but a better solution is required to avoid excessive suture tension on annular tissue. Copyright Published 2020. This article is a U.S. Government work and is in the public domain in the USA.METHODS: An 83-year-old man had end-stage TR caused by a defibrillator lead. He consented to undergo PASTA on a compassionate basis. A double-orifice valve was created with pledgeted sutures from percutaneous right ventricular apical access.OBJECTIVES: We report the first pledget-assisted suture tricuspid annuloplasty (PASTA) in a patient with torrential tricuspid regurgitation (TR).RESULTS: TR was reduced from torrential to trace. The vena contracta reduced to from 23 to 1 mm and annular area reduced from 1817 to 782 mm2 . However, the annulus dehisced and required closure with a percutaneous nitinol plug. The patient was discharged home and was alive 6 months later but with persistent symptoms.All authors: Babaliaros VC, Eng MHK, Greenbaum AB, Khan JM, Lederman RJ, Paone G, Rogers T, Wang DDOriginally published: Catheterization & Cardiovascular Interventions. 2020 May 08Fiscal year: FY2021Fiscal year of original publication: FY2020Digital Object Identifier: Date added to catalog: 2020-07-09
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Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 32385950 Available 32385950

Available online from MWHC library: 1996 - present, Available in print through MWHC library: 1996 - 2006

BACKGROUND: Tricuspid valve regurgitation is a common malignant disease with no commercially available transcatheter therapy. PASTA is a "percutaneous surgical" procedure using pledgeted sutures to create a double-orifice tricuspid valve.

CONCLUSIONS: The anatomy of a double-orifice valve can eliminate TR but a better solution is required to avoid excessive suture tension on annular tissue. Copyright Published 2020. This article is a U.S. Government work and is in the public domain in the USA.

METHODS: An 83-year-old man had end-stage TR caused by a defibrillator lead. He consented to undergo PASTA on a compassionate basis. A double-orifice valve was created with pledgeted sutures from percutaneous right ventricular apical access.

OBJECTIVES: We report the first pledget-assisted suture tricuspid annuloplasty (PASTA) in a patient with torrential tricuspid regurgitation (TR).

RESULTS: TR was reduced from torrential to trace. The vena contracta reduced to from 23 to 1 mm and annular area reduced from 1817 to 782 mm2 . However, the annulus dehisced and required closure with a percutaneous nitinol plug. The patient was discharged home and was alive 6 months later but with persistent symptoms.

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