Impact of Optimal Procedural Result After Transcatheter Edge-to-Edge Tricuspid Valve Repair Results From TRI-SPA Registry

被引：1

作者：

Echarte-Morales, Julio ^{[1
,2
]}

Guerreiro, Claudio E. ^{[1
,2
]}

Freixa, Xavier ^{[3
]}

Arzamendi, Dabit ^{[4
]}

Monivas, Vanessa ^{[5
]}

Carrasco-Chinchilla, Fernando ^{[6
]}

Pan, Manuel ^{[7
]}

Nombela-Franco, Luis ^{[8
]}

Pascual, Isaac ^{[9
]}

Benito-Gonzalez, Tomas ^{[10
]}

Perez, Ruth ^{[11
]}

Gomez-Blazquez, Ivan ^{[12
,13
]}

Amat-Santos, Ignacio J.

Cruz-Gonzalez, Ignacio ^{[14
]}

Sanchez-Recalde, Angel ^{[15
]}

Alvarez, Ana Belen Cid ^{[16
]}

Barreiro-Perez, Manuel

Sanchis, Laura ^{[3
]}

Caneiro-Queija, Berenice

Li, Chi Hion ^{[4
]}

del Trigo, Maria ^{[6
]}

Martinez-Carmona, Jose David ^{[17
]}

Mesa, Dolores ^{[7
]}

Jimenez, Pilar ^{[8
]}

Avanzas, Pablo ^{[9
]}

Cepas-Guillen, Pedro ^{[3
]}

Estevez-Loureiro, Rodrigo ^{[1
,2
,18
]}

机构：

[1] Univ Hosp Alvaro Cunqueiro, Dept Cardiol, Vigo, Spain

[2] Univ Vigo, Univ Hosp Alvaro Cunqueiro, Fdn Biomed Galicia, Dept Cardiol,Cardiovasc Res Grp,Serv Galego Saud, Vigo, Spain

[3] Hosp Clin Barcelona, Cardiovasc Inst, Dept Cardiol, Barcelona, Spain

[4] Univ Autonoma Barcelona, Hosp Santa Creu & St Pau, Div Intervent Cardiol, Barcelona, Spain

[5] Univ Hosp Puerta Hierro Majadahonda, Dept Cardiol, Madrid, Spain

[6] Hosp Univ Virgen Victoria, Unidad Gest Clin Corazon, Malaga, Spain

[7] Univ Cordoba, Hosp Reina Sofia, Dept Cardiol, Inst Maimonides Invest Biomed Cordoba, Cordoba, Spain

[8] Fdn Invest Biomed Hosp Clin San Carlos, Hosp Clin San Carlos, Cardiovasc Inst, Madrid, Spain

[9] Hosp Univ Cent Asturias, Heart Area, Oviedo, Spain

[10] Univ Hosp Leon, Dept Cardiol, Leon, Spain

[11] Univ Hosp A Coruna, Dept Cardiol, La Coruna, Spain

[12] Univ Hosp 12 Octubre, Dept Cardiol, Madrid, Spain

[13] Univ Clin Hosp, Ctr Invest Biomed Red Enfermedades Cardiovasc, Dept Cardiol, Valladolid, Spain

[14] Hosp Univ Salamanca, Ctr Invest Biomed Red Enfermedades Cardiovasc, Inst Invest Biomed Salamanca, Dept Cardiol, Salamanca, Spain

[15] Hosp Univ Ramon & Cajal, Dept Cardiol, Madrid, Spain

[16] Univ Clin Hosp, Ctr Invest Biomed Red Enfermedades Cardiovasc, Dept Cardiol, Santiago De Compostela, Spain

[17] Univ Malaga, CIBERCV, Inst Invest Biomed Malaga, Malaga, Spain

[18] Univ Hosp Alvaro Cunqueiro, Dept Cardiol, Calle Clara Campoamor 341, Vigo 36213, Spain

来源：

JACC-CARDIOVASCULAR INTERVENTIONS | 2024年 / 17卷 / 23期

关键词：

real-world experience; residual; tricuspid regurgitation; tricuspid transcatheter edge-to-edge repair; REGURGITATION; OUTCOMES;

D O I：

10.1016/j.jcin.2024.08.003

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

BACKGROUND Procedural success following tricuspid transcatheter edge-to-edge repair (TEER) has been defined variably over time; however, the consequences of achieving a tricuspid regurgitation (TR) grade of 0/1+ are still unclear. OBJECTIVES This study aimed to assess the predictors and prognostic impact of achieving TR 0/1+ after TEER and its role in clinical events. METHODS This multicenter registry included patients undergoing tricuspid TEER in 15 Spanish centers from June 2020 and May 2023. Patients were categorized into the following groups based on the TR grade after procedure: optimal (0/1+), acceptable (2+), and not acceptable (>= 3+). The primary endpoint was the 1-year composite of all-cause death, heart failure hospitalization, and tricuspid reintervention. Secondary endpoints included each component of the primary endpoint assessed separately, NYHA functional class, and TR grade at follow-up.<br /> RESULTS Among 280 enrolled patients, 120 (42.9%) had residual TR 0/1+, 111 (39.6%) had residual TR 2+, and 49 (17.5%) had residual TR >= 3+. Patients with TR 0/1+ experienced lower rates of the primary endpoint (13% vs 20% vs 31%; log-rank P = 0.036). Residual TR >= 3+ was an independent predictor of primary endpoint (HR: 2.277; P = 0.044). Higher rates of NYHA functional class I or II and sustained TR reduction were seen in the TR 0/1+ group (P < 0.001 for both). A small coaptation gap and absence of septal leaflet tethering were independent predictors of achieving TR 0/1+.<br /> CONCLUSIONS An optimal procedural result after TEER might be associated with improved outcomes. TR coaptation gap and leaflet restriction may aid in assessing suitability for TEER.

引用

页码：2764 / 2777

页数：141

共 24 条

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