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

2024; Elsevier BV; Volume: 26; Issue: 8 Linguagem: Inglês

10.1002/ejhf.3274

1879-0844

Lukas Stolz, Karl‐Patrik Kresoja, Jennifer von Stein, Vera Fortmeier, Benedikt Koell, Wolfgang Rottbauer, Mohammad Kassar, Bjoern Goebel, Paolo Denti, Paul Achouh, Tienush Rassaf, Manuel Barreiro‐Pérez, Peter Boekstegers, Andreas Rück, Philipp M. Doldi, Julia Novotny, Monika Zdanytė, Marianna Adamo, Flavien Vincent, Philipp Schlegel, Ralph Stephan von Bardeleben, Thomas J. Stocker, Ludwig T. Weckbach, Mirjam G. Wild, Stephanie Brunner, Stefan Toggweiler, Julia Grapsa, Tiffany Patterson, Hölger Thiele, Tobias Kister, Mathias H. Konstandin, Éric Van Belle, Marco Metra, Tobias Geisler, Rodrigo Estévez‐Loureiro, Peter Luedike, Nicole Karam, Francesco Maisano, Philipp Lauten, Fabien Praz, Mirjam Keßler, Daniel Kalbacher, Volker Rudolph, Christos Iliadis, Philipp Lurz, Jörg Hausleiter,

Cardiac Imaging and Diagnostics

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 cm 2 ). 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.