![]() ![]() 9As a consequence, any noninvasive method for estimating PCWP, if accurate, would be of interest. However, its insertion is an invasive procedure associated with iatrogenic complications 5–8that may compromise the final outcome. 4Introduced in clinical practice more than 20 yr ago, the pulmonary artery catheter remains the most popular means for continuous monitoring of cardiac index, mixed venous oxygen saturation, pulmonary artery pressure, and pulmonary capillary wedge pressure (PCWP). 1–3Recently, it was demonstrated that the rapid and early normalization of venous oxygen saturation is associated with an improvement in the survival of patients with severe sepsis and septic shock, outlining the importance of cardiorespiratory monitoring. In patients with high-permeability–type pulmonary edema, the determination of pulmonary capillary pressure and cardiac output is of critical importance because these two parameters are essential determinants of the amount of fluid accumulating in the alveolointerstitial space. Indeed, the evaluation of cardiac function, pulmonary hemodynamics, and pulmonary capillary pressure has direct diagnostic and therapeutic implications. All rights reserved.BEDSIDE assessment of cardiorespiratory status is a critical issue in surgical patients with postoperative circulatory shock and/or acute lung injury. Pulmonary capillary wedge pressure Right heart catheterization Transcatheter tricuspid valve repair Tricuspid regurgitation Tricuspid valve.Ĭopyright © 2020 Elsevier B.V. ![]() Patients with a PCWP ≤16 mmHg had a favourable outcome with lower mortality and morbidity gaining more benefit of TTVR. Here we demonstrate that PCWP is a predictive outcome parameter in TTVR patients. Patients with a high PCWP tended to have less TR recurrence (p = 0,059) and lower NYHA class (p = 0.062) after one month of follow-up. Best predicting value was evaluated for the cut-off >16 mmHg (AUC 0.700, 0.552-0.848). Moreover, adjusted with other predictive variables within the univariate analysis (left ventricular ejection fraction, history of smoking, tricuspid annular plane systolic excursion), PCWP remained an endpoint predictor (HR 1.11, 1.003-1.24). High PCWP was associated with increased occurrence of the composite endpoint of death and cardiac readmission (HR 4.67, 1.32-16.55). Kaplan-Meier analysis and log-rank test revealed reduced 6-months event-free survival for patients with high PCWP (>16 mmHg) in comparison to those with low PCWP (≤16 mmHg) (p = 0.009). TTVR included transcatheter tricuspid annuloplasty (13 patients) and edge-to-edge repair. Patient population was categorized into a low and high PCWP group according to the median PCWP of 16 mmHg. A total of 60 patients who underwent right heart catheterization prior to TTVR were included. We evaluated pulmonary capillary wedge pressure (PCWP) as prognostic outcome parameter in patients undergoing transcatheter tricuspid valve repair (TTVR). PCWP is a haemodynamic parameter indicating pulmonary hypertension due to left-sided heart failure. TTVR represents a minimal invasive alternative for patients with tricuspid regurgitation (TR).
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