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Early Feasibility Study of Cardioband Tricuspid System for Functional Tricuspid Regurgitation: 30-Day Outcomes
Authors:Charles J. Davidson  D. Scott Lim  Robert L. Smith  Susheel K. Kodali  Robert M. Kipperman  Mackram F. Eleid  Mark Reisman  Brian Whisenant  Jyothy Puthumana  Sandra Abramson  Dale Fowler  Paul Grayburn  Rebecca T. Hahn  Konstantinos Koulogiannis  Sorin V. Pislaru  Todd Zwink  Michael Minder  Abdellaziz Dahou  William A. Gray
Affiliation:1. Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA;2. Department of Medicine, University of Virginia Health System Hospital, Charlottesville, Virginia, USA;3. Department of Cardiothoracic Surgery, The Heart Hospital Baylor, Texas, USA;4. Department of Medicine, Columbia University Medical Center, New York, New York, USA;5. Department of Cardiovascular Surgery, Morristown Medical Center, Morristown, New Jersey, USA;6. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA;7. Department of Medicine, University of Washington, Seattle, Washington, USA;8. Division of Cardiovascular Diseases, Intermountain Healthcare, Salt Lake City, Utah, USA;9. Division of Cardiology, Main Line Health, Lankenau Medical Center, Wynnewood, Pennsylvania, USA;10. Cardiovascular Research Foundation, New York, New York, USA;11. Edwards Lifesciences, Irvine, California, USA
Abstract:
ObjectivesThe study reports for the first time the 30-day outcomes of the first U.S. study with the Cardioband tricuspid valve reconstruction system for the treatment of functional tricuspid regurgitation (TR).BackgroundIncreasing severity of TR is associated with progressively higher morbidity and mortality; however, treatment options for isolated significant disease are limited.MethodsIn this single-arm, multicenter, prospective Food and Drug Administration–approved early feasibility study (EFS), 30 patients with severe or greater symptomatic functional TR were enrolled who were deemed candidates for transcatheter tricuspid repair with the Cardioband tricuspid system by the local heart team and multidisciplinary screening committee.ResultsThe mean patient age was 77 years, 80% were women, 97% had atrial fibrillation, 70% were in New York Heart Association functional class III to IV with mean left ventricular ejection fraction of 58%, and 27% had severe, 20% massive, and 53% torrential TR. Device success was 93% and all patients were alive at 30 days. Between baseline and 30 days, septolateral tricuspid annular diameter was reduced by 13% (p < 0.001), 85% of patients had ≥1 grade TR reduction and 44% had ≤moderate TR, 75% were in New York Heart Association functional class I to II (p < 0.001), and overall Kansas City Cardiomyopathy Questionnaire score improved by 16 points (p < 0.001).ConclusionsIn patients with severe symptomatic functional TR, this is the first study in the United States with the Cardioband tricuspid system for direct transcatheter annular reduction. This early feasibility study demonstrates high procedural feasibility with no 30-day mortality. There is significant reduction of functional TR with clinically significant improvements in functional status and quality of life. (Edwards Cardioband Tricuspid Valve Reconstruction System Early Feasibility Study; NCT03382457)
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