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Coisne, A; Scotti, A; Taramasso, M; Granada, JF; Ludwig, S; Rodés-Cabau, J; Lurz, P; Hausleiter, J; Fam, N; Kodali, SK; Pozzoli, A; Alessandrini, H; Biasco, L; Brochet, E; Denti, P; Estevez-Loureiro, R; Frerker, C; Ho, EC; Monivas, V; Nickenig, G; Praz, F; Puri, R; Sievert, H; Tang, GHL; Andreas, M; Von Bardeleben, RS; Rommel, KP; Muntané-Carol, G; Gavazzoni, M; Braun, D; Lubos, E; Kalbacher, D; Connelly, KA; Juliard, JM; Harr, C; Pedrazzini, G; Philippon, F; Schofer, J; Thiele, H; Unterhuber, M; Himbert, D; Alcázar, MU; Wild, MG; Jorde, U; Windecker, S; Maisano, F; Md, MBL; Md, RTH; Latib, A.
Prognostic Value of Tricuspid Valve Gradient After Transcatheter Edge-to-Edge Repair
JACC-CARDIOVASC INTE. 2023; 16(6): 706-717. Doi: 10.1016/j.jcin.2023.01.375
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Co-authors Med Uni Graz: Andreas Martin
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Abstract:: BACKGROUND Data regarding the impact of the tricuspid valve gradient (TVG) after tricuspid transcatheter edge-to -edge repair (TEER) are scarce. OBJECTIVES This study sought to evaluate the association between the mean TVG and clinical outcomes among pa-tients who underwent tricuspid TEER for significant tricuspid regurgitation. METHODS Patients with significant tricuspid regurgitation who underwent tricuspid TEER within the TriValve (Inter-national Multisite Transcatheter Tricuspid Valve Therapies) registry were divided into quartiles based on the mean TVG at discharge. The primary endpoint was the composite of all-cause mortality and heart failure hospitalization. Outcomes were assessed up to the 1-year follow-up. RESULTS A total of 308 patients were included from 24 centers. Patients were divided into quartiles of the mean TVG as follows: quartile 1 (n = 77), 0.9 +/- 0.3 mm Hg; quartile 2 (n = 115), 1.8 +/- 0.3 mm Hg; quartile 3 (n = 65), 2.8 +/- 0.3 mm Hg; and quartile 4 (n = 51), 4.7 +/- 2.0 mm Hg. The baseline TVG and the number of implanted clips were associated with a higher post-TEER TVG. There was no significant difference across TVG quartiles in the 1-year composite endpoint (quartiles 1-4: 35%, 30%, 40%, and 34%, respectively; P = 0.60) or the proportion of patients in New York Heart Association class III to IV at the last follow-up (P = 0.63). The results were similar after adjustment for clinical and echocardiographic characteristics (composite endpoint quartile 4 vs quartile 1-quartile 3 adjusted HR: 1.05; 95% CI: 0.52-2.12; P = 0.88) or exploring post-TEER TVG as a continuous variable. CONCLUSIONS In this retrospective analysis of the TriValve registry, an increased discharge TVG was not significantly associated with adverse outcomes after tricuspid TEER. These findings apply for the explored TVG range and up to the 1-year follow-up. Further investigations on higher gradients and longer follow-up are needed to better guide the intraprocedural decision-making process. (J Am Coll Cardiol Intv 2023;16:706-717) (c) 2023 Published by Elsevier on behalf of the American College of Cardiology Foundation.
Find related publications in this database (Keywords): transcatheter edge-to-edge; repair; transcatheter tricuspid valve intervention; tricuspid regurgitation; tricuspid valve gradient