Tricuspid regurgitation after transcatheter mitral valve repair: Clinical course and impact on outcome

Meijerink, Frank; Koch, Karel T.; Winter, Robbert J. de; Robbers‐Visser, Daniëlle; Boekholdt, S. Matthijs; Holierook, Marja; Baan, Jan; Bouma, Berto J.

doi:10.1002/ccd.29464

Cited by 11 publications

(5 citation statements)

References 36 publications

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“…However, RV function as assessed by tricuspid annular plane systolic excursion (TAPSE) was similar in both groups. Disagreeing with our data, Meijerink et al described TR regression as mainly occurring in patients with RV dysfunction at baseline [19].…”

Section: Discussionsupporting

confidence: 82%

Predictors of Improvement in Concomitant Tricuspid Regurgitation Following Transcatheter Edge-to-Edge Mitral Valve Repair

Gröger,

Hirsch,

Felbel

et al. 2023

JCM

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Background: Improvement in concomitant tricuspid regurgitation (TR) after mitral valve transcatheter edge-to-edge repair (M-TEER) for mitral regurgitation (MR) occurs frequently; however factors determining the post-procedural course of TR are not well understood. We investigated the parameters associated with TR improvement after M-TEER. Methods and Results: A total of 300 patients were consecutively included in this retrospective analysis. MR and TR severity as well as heart chamber metrics were assessed before the procedure and at follow-up. Device success was achieved in 97.3% of patients. TR decreased in 30.2% of patients. Patients with improved TR were more often female, had more severe TR at baseline, and their right heart dimensions at baseline trended to be smaller. Female sex (odds ratio (OR) 2.997), baseline MR-Grade (OR 3.181) and baseline TR-Grade (OR 2.653) independently predicted TR reduction. More pronounced right heart reverse remodeling was observed in patients with improved TR. TR regression independently predicted lower mortality (hazard ratio (HR) 0.333, 95% confidence interval 0.112–0.996, p = 0.049). Conclusions: A reduction in concomitant TR severity after M-TEER occurred mainly in females and in patients with high-grade TR and MR at baseline. TR regression is associated with better survival after M-TEER.

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Section: Discussionsupporting

confidence: 82%

Predictors of Improvement in Concomitant Tricuspid Regurgitation Following Transcatheter Edge-to-Edge Mitral Valve Repair

Gröger,

Hirsch,

Felbel

et al. 2023

JCM

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“…Right ventricular function improved in 55% of patients and deterioration of RV function was characterised by excessive mortality [23]. Tricuspid regurgitation improved in 23-35%, and persistence of TR after TMVR was associated with impaired long-term prognosis and decreased symptomatic benefit [17,31,[38][39][40].…”

Section: Discussionmentioning

confidence: 99%

Prognostic Value of Pulmonary Hypertension, Right Ventricular Function and Tricuspid Regurgitation on Mortality After Transcatheter Mitral Valve Repair: A Systematic Review and Meta-Analysis

Meijerink

Witte

Limpens

et al. 2022

Heart, Lung and Circulation

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BackgroundPulmonary hypertension (PH), right ventricular (RV) dysfunction, and tricuspid regurgitation (TR) are commonly present in patients with mitral regurgitation (MR) and known to impair prognosis. This systematic review and meta-analysis aimed to determine the prognostic value of PH, RV function, and TR on mortality after transcatheter mitral valve repair (TMVR). MethodsA systematic search was performed to identify studies investigating PH, RV function, or TR in patients who underwent TMVR. Studies were included for pooled analysis if hazard ratios (HR) for all-cause mortality were given. ResultsA total of 8,672 patients from 21 selected studies were included (PH, 11 studies; RV function, nine studies; TR, 10 studies). Mean follow-up was 2.761.6 years. The HRs and 95% CIs for all-cause mortality of PH (dichotomised: HR 1.70 95% CI 1.00-2.87; per 10 mmHg increase in systolic PAP: HR 1.17 95% CI 1.07-1.29), RV function (dichotomised: HR 1.86 95% CI 1.45-2.38; per 5 mm decrease in TAPSE: HR 1.18 95% CI 0.97-1.43) and TR (HR 1.51 95% CI 1.28-1.79) indicated a significant association. ConclusionPrognosis after TMVR is worse in patients with significant MR when concomitant PH, RV dysfunction, or TR are present. Careful assessment of these parameters should therefore precede clinical decision-making for TMVR. The current results encourage investigation into whether (1) intervention at an earlier stage of MR reduces incidence of PH, RV dysfunction, and TR; and (2) transcatheter treatment of concomitant TR can improve clinical outcome and prognosis for these patients.

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“…The composite endpoint of deaths and rehospitalizations for heart failure was significantly more frequent in the presence of 4+/3+ (67.7 vs. 88.8%; log-rank p = 0.015) [13]. Similarly, Meijerink et al [14] found differences in the prognosis of patients undergoing MitraClip procedures depending on the coexisting tricuspid regurgitation. Survival of patients with severe TR after transcatheter mitral valve repair was 58% after two years compared to 82% for those with non, mild or moderate TR.…”

Section: Discussionmentioning

confidence: 88%

Uzasadnienie zamknięcia jatrogennego ubytku przegrody międzyprzedsionkowej podczas zabiegu MitraClip

Streb

Fiszer²,

Podolecki³

et al. 2022

Folia Cardiologica

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Tricuspid regurgitation after transcatheter mitral valve repair: Clinical course and impact on outcome

Cited by 11 publications

References 36 publications

Predictors of Improvement in Concomitant Tricuspid Regurgitation Following Transcatheter Edge-to-Edge Mitral Valve Repair

Predictors of Improvement in Concomitant Tricuspid Regurgitation Following Transcatheter Edge-to-Edge Mitral Valve Repair

Prognostic Value of Pulmonary Hypertension, Right Ventricular Function and Tricuspid Regurgitation on Mortality After Transcatheter Mitral Valve Repair: A Systematic Review and Meta-Analysis

Uzasadnienie zamknięcia jatrogennego ubytku przegrody międzyprzedsionkowej podczas zabiegu MitraClip

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