Julio Echarte-Morales, Claudio E Guerreiro, Xavier Freixa, Dabit Arzamendi, Vanessa Moñivas, Fernando Carrasco-Chinchilla, Manuel Pan, Luis Nombela-Franco, Isaac Pascual, Tomás Benito-González, Ruth Perez, Iván Gómez-Blázquez, Ignacio J Amat-Santos, Ignacio Cruz-González, Ángel Sánchez-Recalde, Ana Belén Cid Alvarez, Manuel Barreiro-Perez, Laura Sanchis, Berenice Caneiro-Queija, Chi Hion Li, Maria Del Trigo, Jose David Martínez-Carmona, Dolores Mesa, Pilar Jiménez, Pablo Avanzas, Pedro Cepas-Guillén, Rodrigo Estévez-Loureiro
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引用次数: 0
Abstract
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.
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+.
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.
期刊介绍:
JACC: Cardiovascular Interventions is a specialist journal launched by the Journal of the American College of Cardiology (JACC). It covers the entire field of interventional cardiovascular medicine, including cardiac, peripheral, and cerebrovascular interventions. The journal publishes studies that will impact the practice of interventional cardiovascular medicine, including clinical trials, experimental studies, and in-depth discussions by respected experts. To enhance visual understanding, the journal is published both in print and electronically, utilizing the latest technologies.