Transcatheter tricuspid valve edge-to-edge repair reduced 1-year mortality by 46% compared to medical management in patients with severe tricuspid regurgitation and intermediate right ventricular-pulmonary artery coupling (HR 0.54).
Cohort (n=1,885)
Yes
Does T-TEER improve 1-year mortality compared to medical management across different RVPAC tertiles in patients with tricuspid regurgitation?
T-TEER is associated with better survival than medical management in patients with tricuspid regurgitation and intermediate RVPAC, while poor RVPAC indicates high mortality regardless of treatment.
Hazard Ratio: 0.54 (95% CI 0.31–0.94)
p-value: p=0.03
BACKGROUND: Right ventricular-pulmonary artery coupling (RVPAC) predicts outcomes after transcatheter tricuspid valve edge-to-edge repair (T-TEER), but its role in patient selection remains unclear. OBJECTIVES: The aim of this study was to evaluate the prognostic implications of RVPAC in a European registry of patients with tricuspid regurgitation undergoing either T-TEER or medical management. METHODS: Among 1,885 patients with tricuspid regurgitation (n = 585 medical, n = 1,300 T-TEER), 946 were propensity matched (1:1). RVPAC, assessed as the ratio of tricuspid annular plane systolic excursion to systolic pulmonary artery pressure was analyzed for its association with 1-year mortality. RESULTS: ]; P = 0.03) declined. Mortality was highest in the low RVPAC tertile, with no difference between treatment modalities (HR: 1.04; 95% CI: 0.68-1.61; P = 0.85). T-TEER was associated with better survival than medical management in the intermediate RVPAC tertile (HR: 0.54; 95% CI: 0.31-0.94; P = 0.03). This difference persisted but weakened in the high RVPAC tertile, with the overall most favorable outcomes (HR: 0.69; 95% CI: 0.35-1.36; P = 0.27). CONCLUSIONS: Poorer RVPAC reflects higher baseline risk and mortality, regardless of treatment. T-TEER is associated with better survival across a range of RVPAC values, including those less than previously suggested thresholds.
Rommel et al. (2025) conducted a cohort in Severe tricuspid regurgitation (n=1,885). Transcatheter tricuspid valve edge-to-edge repair (T-TEER) vs. Medical management was evaluated on 1-year all-cause mortality (in intermediate RVPAC tertile) (HR 0.54, 95% CI 0.31-0.94, p=0.03). Transcatheter tricuspid valve edge-to-edge repair reduced 1-year mortality by 46% compared to medical management in patients with severe tricuspid regurgitation and intermediate right ventricular-pulmonary artery coupling (HR 0.54).