Impact of concomitant tricuspid regurgitation on outcome after edge‐to‐edge mitral valve repair
Matthias Gröger, Katharina P. Zeiml, Leonhard M. Schneider, Wolfgang Rottbauer, Sinisa Markovic, Mirjam Keßler- Cardiology and Cardiovascular Medicine
- Radiology, Nuclear Medicine and imaging
- General Medicine
Abstract
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.