Prognostic Implications of Residual Tricuspid Regurgitation Grading After Transcatheter Tricuspid Valve Repair

• DOI: 10.1016/j.jcin.2024.04.023
• Publication Date: 2024-05-16T12:48:50Z
• Authors: Julien Dreyfus; Maurizio Taramasso; Karl-Patrik Kresoja; Hazem Omran; Christos Iliadis; Giulio Russo; Marcel Weber; Luis Nombela-Franco; Rodrigo Estevez L...; Jörg Hausleiter; Azeem Latib; Lukas Stolz; Fabien Praz; Stephan Windecker; Jose Luis Zamorano; Ralph Stephan von...; Gilbert H.L. Tang; Rebecca Hahn; Edith Lubos; John Webb; Joachim Schofer; Neil Fam; Alexander Lauten; Giovanni Pedrazzini; Josep Rodés-Cabau; Mohammed Nejjari; Luigi Badano; Hannes Alessandrini; Dominique Himbert; Horst Sievert; Kerstin Piayda; Erwan Donal; Thomas Modine; Georg Nickenig; Roman Pfister; Volker Rudolph; Jordan Bernick; George A. Wells; Jeroen Bax; Philipp Lurz; Maurice Enriquez-...; Francesco Maisano; David Messika-Zei...; Nina Ajmone-Marsan; Hannes Alessandrini; Luigi Badano; Philipp Bartko; Jeroen Bax; Baptiste Bazire; Giovanni Benfari; Jordan Bernick; Yohan Bohbot; Manuel Carnero-Al...; Vincent Chan; Augustin Coisne; Juan Crestanello; Michele De Bonis; Fabien Doguet; Erwan Donal; Julien Dreyfus; Florian Eggenspieler; Maurice Enriquez-...; Andrea Eixerés-Es...; Rodrigo Estevez L...; Damien Eyharts; Neil Fam; Michele Flagiello; Xavier Galloo; Mara Gavazzoni; Gilbert Habib; Rebecca Hahn; Jörg Hausleiter; Gregor Heitzinger; Dominique Himbert; Christos Iliadis; Bernard Iung; Fernando Juarez-C...; Karl-Patrick Kresoja; Azeem Latib; Alexander Lauten; Yoan Lavie-Badie; Thierry Le Tourneau; Pascal Lim; Edith Lubos; Philipp Lurz; Francesco Maisano; Yannick Mbaki; Hector Michelena; Thomas Modine; David Messika-Zei...; Denisa Muraru; Mohammed Nejjari; Georg Nickenig; Martin Nicol; Luis Nombela-Franco; Jean-François Obadia; Hazem Omran; Giovanni Pedrazzini; Roman Pfister; Kerstin Piayda; Fabien Praz; Costin Radu; Kenza Rahmouni El...; Elisabeth Riant; Josep Rodés-Cabau; Volker Rudolph; Tobias Ruf; Giulio Russo; Alessandra Sala; Joachim Schofer; Christine Selton-...; Thomas Senage; Horst Sievert; Lukas Stolz; Gilbert H.L. Tang; Maurizio Taramasso; Jacques Tomasi; Yan Topilsky; Christophe Tribou...; Florence Viau; Ralph Stephan von...; John Webb; Marcel Weber; George A. Wells; Stephan Windecker; Jose Luis Zamorano
• Keywords: Male; Cardiac Catheterization; transcatheter intervention; Time Factors; 610; survival; Severity of Illness Index; Risk Assessment; [SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system; Risk Factors; 617; Humans; Registries; tricuspid regurgitation; Aged; [SDV.IB] Life Sciences [q-bio]/Bioengineering; Heart Valve Prosthesis Implantation; Aged, 80 and over; survival; transcatheter intervention; tricuspid regurgitation;; Middle Aged; Tricuspid Valve Insufficiency; [SDV.MHEP.CSC] Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system; Treatment Outcome; [SDV.IB]Life Sciences [q-bio]/Bioengineering; Female; Tricuspid Valve

The safety profile of transcatheter tricuspid valve (TTV) repair techniques is well established, but residual tricuspid regurgitation (TR) remains a concern.The authors sought to assess the impact of residual TR severity post-TTV repair on survival.We evaluated the survival rate at 2 years of 613 patients with severe isolated functional TR who underwent TTV repair in TRIGISTRY according to the severity of residual TR at discharge using a 3-grade (mild, moderate, and severe) or 4-grade scheme (mild, mild to moderate, moderate to severe, and severe).Residual TR was none/mild in 33%, moderate in 52%, and severe in 15%. The 2-year adjusted survival rates significantly differed between the 3 groups (85%, 70%, and 44%, respectively; restricted mean survival time [RMST]: P = 0.0001). When the 319 patients with moderate residual TR were subdivided into mild to moderate (n = 201, 33%) and moderate to severe (n = 118, 19%), the adjusted survival rate was also significantly different between groups (85%, 80%, 55%, and 44%, respectively; RMST: P = 0.001). Survival was significantly lower in patients with moderate to severe residual TR compared to patients with mild to moderate residual TR (P = 0.006). No difference in survival rates was observed between patients with no/mild and mild to moderate residual TR (P = 0.67) or between patients with moderate to severe and severe residual TR (P = 0.96).The moderate residual TR group was heterogeneous and encompassed patients with markedly different clinical outcomes. Refining TR grade classification with a more granular 4-grade scheme improved outcome prediction. Our results highlight the importance of achieving a mild to moderate or lower residual TR grade during TTV repair, which could define a successful intervention.