Impact of Previous Cardiac Surgery on Outcomes After Tricuspid Valve Transcatheter Edge-to-Edge Repair: Insights from EuroTR.
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История · было → стало
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Grassini Dario, Kresoja Karl-Patrik, von Stein Jennifer, Fortmeier Vera, Pauschinger Christoph, Rottbauer Wolfgang, Kassar Mohammad, Goebel Bjoern, Denti Paolo, Achouh Paul, Rassaf Tienush, Barreiro-Perez Manuel, Boekstegers Peter, Rück Andreas, Zdanyte Monika, Adamo Marianna, Vincent Flavien, Schlegel Philipp, Rosch Sebastian, Wild Mirjam G, Besler Christian, Toggweiler Stefan, Brunner Stephanie, Grapsa Julia, Patterson Tiffany, Thiele Holger, Kister Tobias, Tarantini Giuseppe, Masiero Giulia, De Carlo Marco, Giannini Cristina, Voss Fabian, Polzin Amin, Popolo Rubbio Antonio, Bedogni Francesco, Stolte Thorald, Nestelberger Thomas, Benito-González Tomás, Sánchez-Muñóz Enrique, Vrijkorte Martijn, Swaans Martin, Konstandin Mathias H, Van Belle Eric, Metra Marco, Geisler Tobias, Estévez-Loureiro Rodrigo, Mahabadi Amir Abbas, Karam Nicole, Maisano Francesco, Lauten Philipp, Kessler Mirjam, Kalbacher Daniel, Rudolph Volker, Iliadis Christos, Lurz Philipp, Praz Fabien, Stolz Lukas, Hausleiter Jörg, EuroTR Investigators
Аннотация
OBJECTIVES: This study aimed to evaluate the impact of PCS on outcomes after T-TEER.
METHODS: This analysis included patients from the EuroTR registry (European Registry of Transcatheter Repair for Tricuspid Regurgitation; NCT0630726) who underwent T-TEER for clinically relevant tricuspid regurgitation (TR) between 2016 and 2024 and had available information on cardiac surgical history. Study endpoints were procedural TR reduction, improvement in NYHA functional class, all-cause mortality, and the composite of death or heart failure hospitalization (HFH) at 2 years.
RESULTS: Among 2929 patients, 27.2% had a history of PCS. These patients exhibited a higher comorbidity burden and more advanced right heart remodeling. TR severity at baseline was comparable between groups (P = 0.095), whereas residual TR at discharge and follow-up was higher in patients with PCS (both P < 0.001). PCS independently predicted residual TR ≥ 3 + at discharge (OR: 1.41; 95% CI: 1.11-1.79; P = 0.01). T-TEER was associated with an improvement in NYHA class in patients with and without PCS (≥ 1-class reduction: 66.2% in PCS vs. 59.6% in non-PCS patients; P = 0.15). At 2 years, PCS patients had higher all-cause mortality (HR: 1.25; 95% CI: 1.04-1.50; P = 0.02) and a higher incidence of the composite endpoint of death or HFH (HR: 1.24; 95% CI: 1.05-1.46; P = 0.01).
CONCLUSIONS: PCS is an independent predictor of outcomes in patients undergoing T-TEER, identifying a subgroup with less pronounced TR reduction and lower long-term survival despite significant functional improvement.