High-grade concomitant tricuspid regurgitation did not independently predict mortality up to 12 months after mitral valve transcatheter edge-to-edge repair (HR 1.302; 95% CI 0.937-1.810; P=0.116).
Cohort (n=740)
No
Does high-grade concomitant tricuspid regurgitation independently predict mortality in patients undergoing mitral valve transcatheter edge-to-edge repair?
High-grade concomitant tricuspid regurgitation does not independently predict mortality after mitral valve transcatheter edge-to-edge repair, suggesting a wait-and-observe approach for TR may be reasonable in this population.
Effect estimate: HR 1.302 (95% CI 0.937-1.810)
Absolute Event Rate: 21.5% vs 11.1%
p-value: p=0.116
AIMS: To evaluate the impact of tricuspid regurgitation (TR) on echocardiographic and functional outcome after mitral valve transcatheter edge-to-edge-repair (M-TEER). METHODS AND RESULTS: A total of 740 patients underwent M-TEER at our center from 2010 to 2021. Patients were analyzed according to severity of concomitant TR at the time of M-TEER procedure: low-grade TR (grade ≤I trace-mild, 279 patients 37.7%), moderate TR (grade II, 170 patients 23.0%) and high-grade TR (grade III-V severe-torrential, 291 patients 39.3%). Patients with moderate to high-grade TR had higher morbidity. Procedural success of M-TEER was achieved similarly in all groups (98.2% vs. 97.6% vs. 95.9%, p = 0.22). TR severity decreased rapidly and consistently after M-TEER to only 48.0% of high-grade TR patients after 3 months (p < 0.001) and to 46.8% after 12 months (p = 0.99). High-grade TR patients had significantly higher mortality (21.5% vs. 18.2% vs. 11.1%, p = 0.003) up to 12 months after M-TEER. However, high-grade TR did not independently predict mortality (HR 1.302, 95% CI 0.937-1.810; p = 0.116). Echocardiographic and functional outcome was similar in both secondary and primary MR patients. CONCLUSIONS: High-grade concomitant TR did not independently predict adverse outcome following M-TEER. A wait-and-observe approach for these patients is reasonable.
Gröger et al. (2023) conducted a cohort in Mitral regurgitation with concomitant tricuspid regurgitation (n=740). High-grade concomitant tricuspid regurgitation vs. Low-grade and moderate tricuspid regurgitation was evaluated on Mortality up to 12 months (HR 1.302, 95% CI 0.937-1.810, p=0.116). High-grade concomitant tricuspid regurgitation did not independently predict mortality up to 12 months after mitral valve transcatheter edge-to-edge repair (HR 1.302; 95% CI 0.937-1.810; P=0.116).