Impact of Massive or Torrential Tricuspid Regurgitation in Patients Undergoing Transcatheter Tricuspid Valve Intervention |
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| Affiliation: | 1. Department of Cardiac Surgery, University Hospital Zurich, Zurich, Switzerland;2. Cardiology Department, Asklepios Klinik St. Georg, Hamburg, Germany;3. Cardiology Department, St. Paul Hospital, Vancouver, British Columbia, Canada;4. Cardiology Department, Cardiocentro, Lugano, Switzerland;5. Department of Cardiology, Heart Center Leipzig at University of Leipzig, Leipzig, Germany;6. Cardiology Department, Klinikum der Universität München, Munich, Germany;7. Cardiology Department, Hôpital Bichat, Université Paris VI, Paris, France;8. Cardiology Department, Toronto Heart Center, St. Michael’s Hospital, Toronto, Ontario, Canada;9. Cardiology Department, CardioVascular Center Frankfurt, Frankfurt am Main, Germany;10. Cardiac Surgery Department, San Raffaele University Hospital, Milan, Italy;11. Cardiology Department, University Heart Center Hamburg, Hamburg, Germany;12. Cardiology Department, University Hospital Alvaro Cunqueiro, Vigo, Spain;13. Cardiology Department, University Hospital of Köln, Köln, Germany;14. Cardiology Department, Montefiore Medical Center, New York, New York;15. Cardiology Department, Westchester Medical Center, Valhalla, New York;p. Cardiology Department, NewYork-Presbyterian/Columbia University Medical Center, New York, New York;q. Cardiology Department, University Medical Center Mainz, Mainz, Germany;r. Cardiology Department, Charité University Hospital, Berlin, Germany;s. Cardiology Department, Hospital Universitario Puerta de Hierro, Madrid, Spain;t. Cardiology Department, Quebec Heart and Lung Institute, Laval University, Quebec City, Quebec, Canada;u. Cardiology Department, Universitatsklinikum Bonn, Bonn, Germany;v. Cardiology Department, Inselspital, Bern University Hospital, Bern, Switzerland;w. Cardiology Department, Albertinen Heart Center, Hamburg, Germany;x. Cardiac Surgery Department, Mount Sinai Hospital, New York, New York;y. Cardiology Department, Universite de Paris, Paris, France |
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| Abstract: | ObjectivesThe aim of this study was to assess the clinical outcome of baseline massive or torrential tricuspid regurgitation (TR) after transcatheter tricuspid valve intervention (TTVI).BackgroundThe use of TTVI to treat symptomatic severe TR has been increasing rapidly, but little is known regarding the impact of massive or torrential TR beyond severe TR.MethodsThe study population comprised 333 patients with significant symptomatic TR from the TriValve Registry who underwent TTVI. Mid-term outcomes after TTVI were assessed according to the presence of massive or torrential TR, defined as vena contracta width ≥14 mm. Procedural success was defined as patient survival after successful device implantation and delivery system retrieval, with residual TR ≤2+. The primary endpoint comprised survival rate and freedom from rehospitalization for heart failure, survival rate, and rehospitalization at 1 year.ResultsBaseline massive or torrential TR and severe TR were observed in 154 patients (46.2%) and 179 patients (53.8%), respectively. Patients with massive or torrential TR had a higher prevalence of ascites than those with severe TR (27.3% vs. 20.4%, respectively; p = 0.15) and demonstrated a similar procedural success rate (83.2% vs. 77.3%, respectively; p = 0.21). The incidence of peri-procedural adverse events was low, with no significant between-group differences. Freedom from the composite endpoint was significantly lower in patients with massive or torrential TR than in those with severe TR, which was significantly associated with an increased risk for 1-year death of any cause or rehospitalization for heart failure (adjusted hazard ratio: 1.91; 95% confidence interval: 1.10 to 3.34; p = 0.022). Freedom from the composite endpoint was significantly higher in patients with massive or torrential TR when procedural success was achieved (69.9% vs. 54.2%, p = 0.048).ConclusionsBaseline massive or torrential TR is associated with an increased risk for all-cause mortality and rehospitalization for heart failure 1 year after TTVI. Procedural success is related to better outcomes, even in the presence of baseline massive or torrential TR. (International Multisite Transcatheter Tricuspid Valve Therapies Registry [TriValve]; NCT03416166) |
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| Keywords: | transcatheter tricuspid valve intervention tricuspid regurgitation tricuspid valve TR" },{" #name" :" keyword" ," $" :{" id" :" kwrd0030" }," $$" :[{" #name" :" text" ," _" :" tricuspid regurgitation TTVI" },{" #name" :" keyword" ," $" :{" id" :" kwrd0040" }," $$" :[{" #name" :" text" ," _" :" transcatheter tricuspid valve intervention VCW" },{" #name" :" keyword" ," $" :{" id" :" kwrd0050" }," $$" :[{" #name" :" text" ," _" :" vena contracta width |
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