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Multicenter Study
. 2024 Aug;26(8):1850-1860.
doi: 10.1002/ejhf.3274. Epub 2024 May 29.

Residual tricuspid regurgitation after tricuspid transcatheter edge-to-edge repair: Insights into the EuroTR registry

Lukas Stolz  1 , Karl-Patrik Kresoja  2 , Jennifer von Stein  3 , Vera Fortmeier  4 , Benedikt Koell  5   6 , Wolfgang Rottbauer  7 , Mohammad Kassar  8 , Bjoern Goebel  9 , Paolo Denti  10 , Paul Achouh  11 , Tienush Rassaf  12 , Manuel Barreiro-Perez  13 , Peter Boekstegers  14 , Andreas Rück  15 , Philipp M Doldi  1 , Julia Novotny  1 , Monika Zdanyte  16 , Marianna Adamo  17 , Flavien Vincent  18 , Philipp Schlegel  19 , Ralph-Stephan von Bardeleben  2 , Thomas J Stocker  1   20 , Ludwig T Weckbach  1   20 , Mirjam G Wild  21 , Stephanie Brunner  22 , Stefan Toggweiler  22 , Julia Grapsa  23 , Tiffany Patterson  20 , Holger Thiele  24 , Tobias Kister  24 , Mathias H Konstandin  19 , Eric Van Belle  18 , Marco Metra  17 , Tobias Geisler  16 , Rodrigo Estévez-Loureiro  13 , Peter Luedike  12 , Nicole Karam  11 , Francesco Maisano  10 , Philipp Lauten  9 , Fabien Praz  8 , Mirjam Kessler  7 , Daniel Kalbacher  5   6 , Volker Rudolph  4 , Christos Iliadis  3 , Philipp Lurz  2 , Jörg Hausleiter  1   25 ; on behalf of the EuroTR Investigators
Collaborators, Affiliations
Free article
Multicenter Study

Residual tricuspid regurgitation after tricuspid transcatheter edge-to-edge repair: Insights into the EuroTR registry

Lukas Stolz et al. Eur J Heart Fail. 2024 Aug.
Free article

Abstract

Aims: Data on the prognostic impact of residual tricuspid regurgitation (TR) after tricuspid transcatheter edge-to-edge repair (T-TEER) are scarce. The aim of this analysis was to evaluate 2-year survival and symptomatic outcomes of patients in relation to residual TR after T-TEER.

Methods and results: Using the large European Registry of Transcatheter Repair for Tricuspid Regurgitation (EuroTR registry) we investigated the impact of residual TR on 2-year all-cause mortality and New York Heart Association (NYHA) functional class at follow-up. The study further identified predictors for residual TR ≥3+ using a logistic regression model. The study included a total of 1286 T-TEER patients (mean age 78.0 ± 8.9 years, 53.6% female). TR was successfully reduced to ≤1+ in 42.4%, 2+ in 40.0% and 3+ in 14.9% of patients at discharge, while 2.8% remained with TR ≥4+ after the procedure. Residual TR ≥3+ was an independent multivariable predictor of 2-year all-cause mortality (hazard ratio 2.06, 95% confidence interval 1.30-3.26, p = 0.002). The prevalence of residual TR ≥3+ was four times higher in patients with higher baseline TR (vena contracta >11.1 mm) and more severe tricuspid valve tenting (tenting area >1.92 cm2). Of note, no survival difference was observed in patients with residual TR ≤1+ versus 2+ (76.2% vs. 73.1%, p = 0.461). The rate of NYHA functional class ≥III at follow-up was significantly higher in patients with residual TR ≥3+ (52.4% vs. 40.5%, p < 0.001). Of note, the degree of TR reduction significantly correlated with the extent of symptomatic improvement (p = 0.012).

Conclusions: T-TEER effectively reduced TR severity in the majority of patients. While residual TR ≥3+ was associated with worse outcomes, no differences were observed for residual TR 1+ versus 2+. Symptomatic improvement correlated with the degree of TR reduction.

Keywords: Procedural success; Residual tricuspid regurgitation; Tricuspid regurgitation; Tricuspid regurgitation reduction.

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References

    1. Topilsky Y, Nkomo VT, Vatury O, Michelena HI, Letourneau T, Suri RM, et al. Clinical outcome of isolated tricuspid regurgitation. JACC Cardiovasc Imaging 2014;7:1185–1194. https://doi.org/10.1016/j.jcmg.2014.07.018
    1. Topilsky Y, Maltais S, Medina Inojosa J, Oguz D, Michelena H, Maalouf J, et al. Burden of tricuspid regurgitation in patients diagnosed in the community setting. JACC Cardiovasc Imaging 2019;12:433–442. https://doi.org/10.1016/j.jcmg.2018.06.014
    1. Nath J, Foster E, Heidenreich PA. Impact of tricuspid regurgitation on long‐term survival. J Am Coll Cardiol 2004;43:405–409. https://doi.org/10.1016/j.jacc.2003.09.036
    1. Stolz L, Doldi PM, Weckbach LT, Stocker TJ, Braun D, Orban M, et al. Right ventricular function in transcatheter mitral and tricuspid valve edge‐to‐edge repair. Front Cardiovasc Med 2022;9:993618. https://doi.org/10.3389/fcvm.2022.993618
    1. Orban M, Rommel KP, Ho EC, Unterhuber M, Pozzoli A, Connelly KA, et al. Transcatheter edge‐to‐edge tricuspid repair for severe tricuspid regurgitation reduces hospitalizations for heart failure. JACC Heart Fail 2020;8:265–276. https://doi.org/10.1016/j.jchf.2019.12.006

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