1-Year Outcomes After Edge-to-Edge Valve Repair for Symptomatic Tricuspid Regurgitation: Results From the TriValve Registry.

Mehr, Michael; Taramasso, Maurizio; Besler, Christian; Ruf, Tobias; Connelly, Kim A; Weber, Marcel; Yzeiraj, Ermela; Schiavi, Davide; Mangieri, Antonio; Vaskelyte, Laura; Alessandrini, Hannes; Deuschl, Florian; Brugger, Nicolas; Ahmad, Hasan; Biasco, Luigi; Orban, Mathias; Deseive, Simon; Braun, Daniel; Rommel, Karl-Philipp; Pozzoli, Alberto; ... (2019). 1-Year Outcomes After Edge-to-Edge Valve Repair for Symptomatic Tricuspid Regurgitation: Results From the TriValve Registry. JACC. Cardiovascular Interventions, 12(15), pp. 1451-1461. Elsevier 10.1016/j.jcin.2019.04.019

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OBJECTIVES The purpose of this study was to evaluate procedural and 1-year clinical and echocardiographic outcomes of patients treated with tricuspid edge-to-edge repair. BACKGROUND Transcatheter edge-to-edge repair has been successfully performed in selected patients with symptomatic tricuspid regurgitation (TR) and high risk for surgery, but outcome data are sparse. METHODS This analysis of the multicenter international TriValve (Transcatheter Tricuspid Valve Therapies) registry included 249 patients with severe TR treated with edge-to-edge repair in compassionate and/or off-label use. Clinical and echocardiographic outcomes were prospectively collected and retrospectively analyzed. RESULTS In 249 patients (mean age 77 ± 9 years; European System for Cardiac Operative Risk Evaluation II score 6.4% [interquartile range: 3.9% to 13.9%]), a successful procedure with TR reduction to grade ≤2+ was achieved in 77% by placement of 2 ± 1 tricuspid clips. Concomitant treatment of severe TR and mitral regurgitation was performed in 52% of patients. At 1-year follow-up, significant and durable improvements in TR severity (TR ≤2+ in 72% of patients) and New York Heart Association functional class (≤II in 69% of patients) were observed. All-cause mortality was 20%, and the combined rate of mortality and unplanned hospitalization for heart failure was 35%. Predictors of procedural failure included effective regurgitant orifice area, tricuspid coaptation gap, tricuspid tenting area, and absence of central or anteroseptal TR jet location. Predictors of 1-year mortality were procedural failure, worsening kidney function, and absence of sinus rhythm. CONCLUSIONS Transcatheter tricuspid edge-to-edge repair can achieve TR reduction at 1 year, resulting in significant clinical improvement. Predictors of procedural failure and 1-year mortality identified here may help select patients who will benefit most from this therapy.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Windecker, Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1876-7605

Publisher:

Elsevier

Language:

English

Submitter:

Nadia Biscozzo

Date Deposited:

11 Feb 2020 07:15

Last Modified:

11 Feb 2020 07:15

Publisher DOI:

10.1016/j.jcin.2019.04.019

PubMed ID:

31395215

Uncontrolled Keywords:

TR edge-to-edge repair heart failure structural heart disease tricuspid valve interventional repair

BORIS DOI:

10.7892/boris.139127

URI:

https://boris.unibe.ch/id/eprint/139127

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