First-in-human transcatheter pledget-assisted suture tricuspid annuloplasty for severe tricuspid insufficiency.
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
Item type | Current library | Collection | Call number | Status | Date due | Barcode |
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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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