Impact of inferior vena cava entry characteristics on tricuspid annular access during transcatheter interventions

Lauren S. Ranard; Torsten P. Vahl; Christine J. Chung; Shirin Sadri; Omar K. Khalique; Nadira Hamid; Tamim Nazif; Isaac George; Vivian Ng; Amisha Patel; Carolina P. Rezende; Mark Reisman; Azeem Latib; Jörg Hausleiter; Paul Sorajja; Vinayak N. Bapat; Gilbert H.L. Tang; Charles J. Davidson; Firas Zahr; Raj Makkar; Neil P. Fam; Juan F. Granada; Martin B. Leon; Rebecca T. Hahn; Susheel Kodali

doi:10.1002/ccd.30048

Impact of inferior vena cava entry characteristics on tricuspid annular access during transcatheter interventions

Lauren S. Ranard, Torsten P. Vahl, Christine J. Chung, Shirin Sadri, Omar K. Khalique, Nadira Hamid, Tamim Nazif, Isaac George, Vivian Ng, Amisha Patel, Carolina P. Rezende, Mark Reisman, Azeem Latib, Jörg Hausleiter, Paul Sorajja, Vinayak N. Bapat, Gilbert H.L. Tang, Charles J. Davidson, Firas Zahr, Raj MakkarNeil P. Fam, Juan F. Granada, Martin B. Leon, Rebecca T. Hahn, Susheel Kodali^*

^*Corresponding author for this work

Medicine, Cardiology Division

Research output: Contribution to journal › Article › peer-review

13 Scopus citations

Abstract

Objectives: The purpose of this study was to characterize the anatomic relationship between the inferior vena cava (IVC) and tricuspid annulus (TA) and its potential impact on the performance of transcatheter TV interventions. Background: Transcatheter tricuspid valve (TV) interventions are emerging as a therapeutic alternative for the treatment of severe, symptomatic tricuspid regurgitation (TR). Progression of TR is associated with right heart dilatation. These anatomic changes may distort the IVC–TA relationship and impact successful implantation of transcatheter devices. Methods: Fifty patients who presented with symptomatic TR for consideration of transcatheter TV therapy with an available CT were included in the study. Comprehensive transesophageal echocardiogram and CT analyses were performed to assess the right-sided cardiac chambers, TA and IVC–TA relationship. Results: The mean age of the study cohort was 78.4 ± 8.9 years. Torrential TR was present in 54% (n = 27). There was considerable variation in the short axis mid-IVC to mid-TA offset (SAX_MID 18.2 ± 7.9 mm, range 4.7–42.1 mm). Conclusions: The IVC-to-TA relationship exhibits significant variability in patients with symptomatic TR. CT analysis of the tricuspid anatomy, including the relationship to the surrounding structures and the IVC, is essential for planning transcatheter TV interventions. Further studies are needed to define whether the IVC-to-TA relationship is a predictor of technical success in the context of specific transcatheter delivery systems.

Original language	English (US)
Pages (from-to)	1268-1276
Number of pages	9
Journal	Catheterization and Cardiovascular Interventions
Volume	99
Issue number	4
DOIs	https://doi.org/10.1002/ccd.30048
State	Published - Mar 1 2022

Funding

Torsten Vahl reports institutional funding to Columbia University Irving Medical Center from Boston Scientific, Edwards Lifesciences, JenaValve, Medtronic, and Siemens Healthineers and he personally received consulting fees from Abbott Vascular, Boston Scientific, and Siemens Healthineers. Omar Khalique reports that he is part of a corelab contracting with JenaValve but he has not received any direct compensation; he further reports consulting fees from Abbott Structural, Boston Scientific, and speaker's bureau fees from Edwards Lifesciences. Nadira Hamid reports that she is part of a corelab contracting with JenaValve but she has not received any direct compensation. Rebecca Hahn reports speaker fees from Edwards Lifescience; consulting for Abbott Structural, Edwards Lifesciences, Gore&Associates, Medtronic, Navigate, and Philips Healthcare; nonfinancial support from 3mensio; Equity with Navigate; and is the Chief Scientific Officer for the Echocardiography Core Laboratory at the Cardiovascular Research Foundation for multiple industry‐sponsored trials, for which she receives no direct industry compensation. Tamim Nazif reports consulting or honoraria for Edwards Lifesciences, Medtronic, Venus Medtech, and Boston Scientific. Martin Leon reports institutional clinical research grants from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic, and JenaValve; he is also a nonpaid chairman and part of the JenaValve steering committee. Susheel Kodali reports the following disclosures: consultant (honoraria) ‐ Admedus, Meril Lifesciences, JenaValve, Abbott Vascular; scientific advisory boards (equity) ‐ Dura Biotech, MicroInterventional Devices, Thubrikar Aortic Valve Inc, Supira, Admedus, and institutional funding to Columbia University and/or Cardiovascular Research Foundation from ‐ Edwards Lifesciences, Medtronic, Abbott Vascular, Boston Scientific, JenaValve. Isaac George reports consulting fees from WL Gore, Vdyne, CardioMech, and Mitremedical; as well as consulting fees from Atricure. Azeem Latib reports the following disclosures: consultant (honoraria) ‐ Edwards Lifesciences, Abbott Vascular; Boston Scientific, Medtronic, Philips, WL Gore; Scientific Advisory Boards (equity) ‐ Tioga, Supira, NeoChord, CorFlow, VVital, and Institutional Funding to Montefiore Medical Center from ‐ Edwards Lifesciences, Medtronic, Abbott Vascular, Boston Scientific. Neil Fam is a consultant to Edwards Lifesciences and Abbott. Juan Granada is a cofounder and equity shareholder for Cephea Valve Technologies (Abbott Vascular). Charles Davidson reports the following disclosures: research support and consulting fees from Edwards Lifesciences and research support from Abbott Vascular. Gilbert Tang is a consultant for Abbott, Medtronic and W. L. Gore & Associates. All other authors have no relevant disclosures to report.

Keywords

transcatheter tricuspid repair
transcatheter tricuspid replacement
tricuspid regurgitation

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine
Radiology Nuclear Medicine and imaging

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10.1002/ccd.30048

Cite this

Ranard, L. S., Vahl, T. P., Chung, C. J., Sadri, S., Khalique, O. K., Hamid, N., Nazif, T., George, I., Ng, V., Patel, A., Rezende, C. P., Reisman, M., Latib, A., Hausleiter, J., Sorajja, P., Bapat, V. N., Tang, G. H. L., Davidson, C. J., Zahr, F., ... Kodali, S. (2022). Impact of inferior vena cava entry characteristics on tricuspid annular access during transcatheter interventions. Catheterization and Cardiovascular Interventions, 99(4), 1268-1276. https://doi.org/10.1002/ccd.30048

@article{1996915ff1f4403f83d67ffcb798c7d3,

title = "Impact of inferior vena cava entry characteristics on tricuspid annular access during transcatheter interventions",

abstract = "Objectives: The purpose of this study was to characterize the anatomic relationship between the inferior vena cava (IVC) and tricuspid annulus (TA) and its potential impact on the performance of transcatheter TV interventions. Background: Transcatheter tricuspid valve (TV) interventions are emerging as a therapeutic alternative for the treatment of severe, symptomatic tricuspid regurgitation (TR). Progression of TR is associated with right heart dilatation. These anatomic changes may distort the IVC–TA relationship and impact successful implantation of transcatheter devices. Methods: Fifty patients who presented with symptomatic TR for consideration of transcatheter TV therapy with an available CT were included in the study. Comprehensive transesophageal echocardiogram and CT analyses were performed to assess the right-sided cardiac chambers, TA and IVC–TA relationship. Results: The mean age of the study cohort was 78.4 ± 8.9 years. Torrential TR was present in 54% (n = 27). There was considerable variation in the short axis mid-IVC to mid-TA offset (SAXMID 18.2 ± 7.9 mm, range 4.7–42.1 mm). Conclusions: The IVC-to-TA relationship exhibits significant variability in patients with symptomatic TR. CT analysis of the tricuspid anatomy, including the relationship to the surrounding structures and the IVC, is essential for planning transcatheter TV interventions. Further studies are needed to define whether the IVC-to-TA relationship is a predictor of technical success in the context of specific transcatheter delivery systems.",

keywords = "transcatheter tricuspid repair, transcatheter tricuspid replacement, tricuspid regurgitation",

author = "Ranard, {Lauren S.} and Vahl, {Torsten P.} and Chung, {Christine J.} and Shirin Sadri and Khalique, {Omar K.} and Nadira Hamid and Tamim Nazif and Isaac George and Vivian Ng and Amisha Patel and Rezende, {Carolina P.} and Mark Reisman and Azeem Latib and J{\"o}rg Hausleiter and Paul Sorajja and Bapat, {Vinayak N.} and Tang, {Gilbert H.L.} and Davidson, {Charles J.} and Firas Zahr and Raj Makkar and Fam, {Neil P.} and Granada, {Juan F.} and Leon, {Martin B.} and Hahn, {Rebecca T.} and Susheel Kodali",

note = "Funding Information: Torsten Vahl reports institutional funding to Columbia University Irving Medical Center from Boston Scientific, Edwards Lifesciences, JenaValve, Medtronic, and Siemens Healthineers and he personally received consulting fees from Abbott Vascular, Boston Scientific, and Siemens Healthineers. Omar Khalique reports that he is part of a corelab contracting with JenaValve but he has not received any direct compensation; he further reports consulting fees from Abbott Structural, Boston Scientific, and speaker's bureau fees from Edwards Lifesciences. Nadira Hamid reports that she is part of a corelab contracting with JenaValve but she has not received any direct compensation. Rebecca Hahn reports speaker fees from Edwards Lifescience; consulting for Abbott Structural, Edwards Lifesciences, Gore&Associates, Medtronic, Navigate, and Philips Healthcare; nonfinancial support from 3mensio; Equity with Navigate; and is the Chief Scientific Officer for the Echocardiography Core Laboratory at the Cardiovascular Research Foundation for multiple industry‐sponsored trials, for which she receives no direct industry compensation. Tamim Nazif reports consulting or honoraria for Edwards Lifesciences, Medtronic, Venus Medtech, and Boston Scientific. Martin Leon reports institutional clinical research grants from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic, and JenaValve; he is also a nonpaid chairman and part of the JenaValve steering committee. Susheel Kodali reports the following disclosures: consultant (honoraria) ‐ Admedus, Meril Lifesciences, JenaValve, Abbott Vascular; scientific advisory boards (equity) ‐ Dura Biotech, MicroInterventional Devices, Thubrikar Aortic Valve Inc, Supira, Admedus, and institutional funding to Columbia University and/or Cardiovascular Research Foundation from ‐ Edwards Lifesciences, Medtronic, Abbott Vascular, Boston Scientific, JenaValve. Isaac George reports consulting fees from WL Gore, Vdyne, CardioMech, and Mitremedical; as well as consulting fees from Atricure. Azeem Latib reports the following disclosures: consultant (honoraria) ‐ Edwards Lifesciences, Abbott Vascular; Boston Scientific, Medtronic, Philips, WL Gore; Scientific Advisory Boards (equity) ‐ Tioga, Supira, NeoChord, CorFlow, VVital, and Institutional Funding to Montefiore Medical Center from ‐ Edwards Lifesciences, Medtronic, Abbott Vascular, Boston Scientific. Neil Fam is a consultant to Edwards Lifesciences and Abbott. Juan Granada is a cofounder and equity shareholder for Cephea Valve Technologies (Abbott Vascular). Charles Davidson reports the following disclosures: research support and consulting fees from Edwards Lifesciences and research support from Abbott Vascular. Gilbert Tang is a consultant for Abbott, Medtronic and W. L. Gore & Associates. All other authors have no relevant disclosures to report. Publisher Copyright: {\textcopyright} 2022 Wiley Periodicals LLC.",

year = "2022",

month = mar,

day = "1",

doi = "10.1002/ccd.30048",

language = "English (US)",

volume = "99",

pages = "1268--1276",

journal = "Catheterization and Cardiovascular Interventions",

issn = "1522-1946",

publisher = "John Wiley and Sons Inc.",

number = "4",

}

Ranard, LS, Vahl, TP, Chung, CJ, Sadri, S, Khalique, OK, Hamid, N, Nazif, T, George, I, Ng, V, Patel, A, Rezende, CP, Reisman, M, Latib, A, Hausleiter, J, Sorajja, P, Bapat, VN, Tang, GHL, Davidson, CJ, Zahr, F, Makkar, R, Fam, NP, Granada, JF, Leon, MB, Hahn, RT & Kodali, S 2022, 'Impact of inferior vena cava entry characteristics on tricuspid annular access during transcatheter interventions', Catheterization and Cardiovascular Interventions, vol. 99, no. 4, pp. 1268-1276. https://doi.org/10.1002/ccd.30048

TY - JOUR

T1 - Impact of inferior vena cava entry characteristics on tricuspid annular access during transcatheter interventions

AU - Ranard, Lauren S.

AU - Vahl, Torsten P.

AU - Chung, Christine J.

AU - Sadri, Shirin

AU - Khalique, Omar K.

AU - Hamid, Nadira

AU - Nazif, Tamim

AU - George, Isaac

AU - Ng, Vivian

AU - Patel, Amisha

AU - Rezende, Carolina P.

AU - Reisman, Mark

AU - Latib, Azeem

AU - Hausleiter, Jörg

AU - Sorajja, Paul

AU - Bapat, Vinayak N.

AU - Tang, Gilbert H.L.

AU - Davidson, Charles J.

AU - Zahr, Firas

AU - Makkar, Raj

AU - Fam, Neil P.

AU - Granada, Juan F.

AU - Leon, Martin B.

AU - Hahn, Rebecca T.

AU - Kodali, Susheel

N1 - Funding Information: Torsten Vahl reports institutional funding to Columbia University Irving Medical Center from Boston Scientific, Edwards Lifesciences, JenaValve, Medtronic, and Siemens Healthineers and he personally received consulting fees from Abbott Vascular, Boston Scientific, and Siemens Healthineers. Omar Khalique reports that he is part of a corelab contracting with JenaValve but he has not received any direct compensation; he further reports consulting fees from Abbott Structural, Boston Scientific, and speaker's bureau fees from Edwards Lifesciences. Nadira Hamid reports that she is part of a corelab contracting with JenaValve but she has not received any direct compensation. Rebecca Hahn reports speaker fees from Edwards Lifescience; consulting for Abbott Structural, Edwards Lifesciences, Gore&Associates, Medtronic, Navigate, and Philips Healthcare; nonfinancial support from 3mensio; Equity with Navigate; and is the Chief Scientific Officer for the Echocardiography Core Laboratory at the Cardiovascular Research Foundation for multiple industry‐sponsored trials, for which she receives no direct industry compensation. Tamim Nazif reports consulting or honoraria for Edwards Lifesciences, Medtronic, Venus Medtech, and Boston Scientific. Martin Leon reports institutional clinical research grants from Abbott, Boston Scientific, Edwards Lifesciences, Medtronic, and JenaValve; he is also a nonpaid chairman and part of the JenaValve steering committee. Susheel Kodali reports the following disclosures: consultant (honoraria) ‐ Admedus, Meril Lifesciences, JenaValve, Abbott Vascular; scientific advisory boards (equity) ‐ Dura Biotech, MicroInterventional Devices, Thubrikar Aortic Valve Inc, Supira, Admedus, and institutional funding to Columbia University and/or Cardiovascular Research Foundation from ‐ Edwards Lifesciences, Medtronic, Abbott Vascular, Boston Scientific, JenaValve. Isaac George reports consulting fees from WL Gore, Vdyne, CardioMech, and Mitremedical; as well as consulting fees from Atricure. Azeem Latib reports the following disclosures: consultant (honoraria) ‐ Edwards Lifesciences, Abbott Vascular; Boston Scientific, Medtronic, Philips, WL Gore; Scientific Advisory Boards (equity) ‐ Tioga, Supira, NeoChord, CorFlow, VVital, and Institutional Funding to Montefiore Medical Center from ‐ Edwards Lifesciences, Medtronic, Abbott Vascular, Boston Scientific. Neil Fam is a consultant to Edwards Lifesciences and Abbott. Juan Granada is a cofounder and equity shareholder for Cephea Valve Technologies (Abbott Vascular). Charles Davidson reports the following disclosures: research support and consulting fees from Edwards Lifesciences and research support from Abbott Vascular. Gilbert Tang is a consultant for Abbott, Medtronic and W. L. Gore & Associates. All other authors have no relevant disclosures to report. Publisher Copyright: © 2022 Wiley Periodicals LLC.

PY - 2022/3/1

Y1 - 2022/3/1

N2 - Objectives: The purpose of this study was to characterize the anatomic relationship between the inferior vena cava (IVC) and tricuspid annulus (TA) and its potential impact on the performance of transcatheter TV interventions. Background: Transcatheter tricuspid valve (TV) interventions are emerging as a therapeutic alternative for the treatment of severe, symptomatic tricuspid regurgitation (TR). Progression of TR is associated with right heart dilatation. These anatomic changes may distort the IVC–TA relationship and impact successful implantation of transcatheter devices. Methods: Fifty patients who presented with symptomatic TR for consideration of transcatheter TV therapy with an available CT were included in the study. Comprehensive transesophageal echocardiogram and CT analyses were performed to assess the right-sided cardiac chambers, TA and IVC–TA relationship. Results: The mean age of the study cohort was 78.4 ± 8.9 years. Torrential TR was present in 54% (n = 27). There was considerable variation in the short axis mid-IVC to mid-TA offset (SAXMID 18.2 ± 7.9 mm, range 4.7–42.1 mm). Conclusions: The IVC-to-TA relationship exhibits significant variability in patients with symptomatic TR. CT analysis of the tricuspid anatomy, including the relationship to the surrounding structures and the IVC, is essential for planning transcatheter TV interventions. Further studies are needed to define whether the IVC-to-TA relationship is a predictor of technical success in the context of specific transcatheter delivery systems.

AB - Objectives: The purpose of this study was to characterize the anatomic relationship between the inferior vena cava (IVC) and tricuspid annulus (TA) and its potential impact on the performance of transcatheter TV interventions. Background: Transcatheter tricuspid valve (TV) interventions are emerging as a therapeutic alternative for the treatment of severe, symptomatic tricuspid regurgitation (TR). Progression of TR is associated with right heart dilatation. These anatomic changes may distort the IVC–TA relationship and impact successful implantation of transcatheter devices. Methods: Fifty patients who presented with symptomatic TR for consideration of transcatheter TV therapy with an available CT were included in the study. Comprehensive transesophageal echocardiogram and CT analyses were performed to assess the right-sided cardiac chambers, TA and IVC–TA relationship. Results: The mean age of the study cohort was 78.4 ± 8.9 years. Torrential TR was present in 54% (n = 27). There was considerable variation in the short axis mid-IVC to mid-TA offset (SAXMID 18.2 ± 7.9 mm, range 4.7–42.1 mm). Conclusions: The IVC-to-TA relationship exhibits significant variability in patients with symptomatic TR. CT analysis of the tricuspid anatomy, including the relationship to the surrounding structures and the IVC, is essential for planning transcatheter TV interventions. Further studies are needed to define whether the IVC-to-TA relationship is a predictor of technical success in the context of specific transcatheter delivery systems.

KW - transcatheter tricuspid repair

KW - transcatheter tricuspid replacement

KW - tricuspid regurgitation

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U2 - 10.1002/ccd.30048

DO - 10.1002/ccd.30048

M3 - Article

C2 - 35084803

AN - SCOPUS:85123770737

SN - 1522-1946

VL - 99

SP - 1268

EP - 1276

JO - Catheterization and Cardiovascular Interventions

JF - Catheterization and Cardiovascular Interventions

IS - 4

ER -

Impact of inferior vena cava entry characteristics on tricuspid annular access during transcatheter interventions

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