Previous cardiac surgery in patients undergoing T-TEER was associated with a higher 2-year incidence of death or heart failure hospitalization (HR 1.24; 95% CI 1.05-1.46; P=0.01).
Observational (n=2,929)
Yes
Does a history of previous cardiac surgery worsen clinical and procedural outcomes in patients undergoing tricuspid valve transcatheter edge-to-edge repair for clinically relevant tricuspid regurgitation?
Previous cardiac surgery is an independent predictor of worse long-term survival and less effective tricuspid regurgitation reduction following T-TEER, despite similar functional improvements.
Effect estimate: HR 1.24 (95% CI 1.05-1.46)
p-value: p=0.01
Background Data on the association of previous cardiac surgery (PCS) with outcomes following tricuspid valve transcatheter edge-to-edge repair (T-TEER) are limited.Objectives This study aimed to evaluate the impact of PCS on outcomes after T-TEER.Methods This analysis included patients from the EuroTR registry (European Registry of Transcatheter Repair for Tricuspid Regurgitation; NCT0630726) who underwent T-TEER for clinically relevant tricuspid regurgitation (TR) between 2016 and 2024 and had available information on cardiac surgical history. Study endpoints were procedural TR reduction, improvement in NYHA functional class, all-cause mortality, and the composite of death or heart failure hospitalization (HFH) at 2 years.Results Among 2929 patients, 27.2% had a history of PCS. These patients exhibited a higher comorbidity burden and more advanced right heart remodeling. TR severity at baseline was comparable between groups (P = 0.095), whereas residual TR at discharge and follow-up was higher in patients with PCS (both P < 0.001). PCS independently predicted residual TR ≥ 3 + at discharge (OR: 1.41; 95% CI: 1.11-1.79; P = 0.01). T-TEER was associated with an improvement in NYHA class in patients with and without PCS (≥ 1-class reduction: 66.2% in PCS vs. 59.6% in non-PCS patients; P = 0.15). At 2 years, PCS patients had higher all-cause mortality (HR: 1.25; 95% CI: 1.04-1.50; P = 0.02) and a higher incidence of the composite endpoint of death or HFH (HR: 1.24; 95% CI: 1.05-1.46; P = 0.01).Conclusions PCS is an independent predictor of outcomes in patients undergoing T-TEER, identifying a subgroup with less pronounced TR reduction and lower long-term survival despite significant functional improvement.
Grassini et al. (2026) conducted an observational in Clinically relevant tricuspid regurgitation (TR) (n=2,929). Previous cardiac surgery (PCS) vs. No previous cardiac surgery was evaluated on Composite of death or heart failure hospitalization (HFH) at 2 years (HR 1.24, 95% CI 1.05-1.46, p=0.01). Previous cardiac surgery in patients undergoing T-TEER was associated with a higher 2-year incidence of death or heart failure hospitalization (HR 1.24; 95% CI 1.05-1.46; P=0.01).