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Войти в исследования Tricuspid Valve Transcatheter Edge-to-Edge Repair in Patients With Cardiac Implantable Electronic Devices: Insights From EuroTR.
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von Stein Jennifer, von Stein Philipp, Pfister Roman, Kresoja Karl-Patrik, Fortmeier Vera, Koell Benedikt, 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, Sticchi Alessandro, Voss Fabian, Polzin Amin, Rubbio Antonio P, Bedogni Francesco, Stolte Thorald, Nestelberger Thomas, Benito González Tomás, Konstandin Mathias H, Van Belle Eric, Metra Marco, Geisler Tobias, Estévez-Loureiro Rodrigo, Mahabadi Amir A, Karam Nicole, Maisano Francesco, Lauten Philipp, Praz Fabien, Kessler Mirjam, Kalbacher Daniel, Rudolph Volker, Lurz Philipp, Granada Juan F, Hausleiter Jörg, Stolz Lukas, Iliadis Christos, EuroTR Investigators
Аннотация
OBJECTIVES: The aim of this study was to evaluate procedural and clinical outcomes of T-TEER in patients with CIED leads in a real-world cohort.
METHODS: Among 3,025 patients undergoing T-TEER at 26 centers (2016-2024), 851 (28.1%) had transvalvular CIED leads. Residual TR at discharge and follow-up and the composite of all-cause mortality or heart failure hospitalization at 2 years were assessed. CIED function was evaluated preprocedure and postprocedure. Propensity score matching (1:1) was conducted to compare outcomes between patients with and those without CIEDs.
RESULTS: CIED function remained stable, and no lead revision was required. At discharge, TR ≤1+ and ≤2+ was achieved in 39.9% and 79.8%, respectively; at follow-up (median 269 days; Q1-Q3: 63-423 days), TR ≤1+ and ≤2+ persisted in 29.3% and 69.1%. In 385 matched pairs, residual TR, functional status, and 2-year heart failure hospitalization-free survival were comparable between patients with and those without CIEDs (67.1% [95% CI: 62.1%-72.5%] vs 73.6% [95% CI: 68.9%-78.6%]; P = 0.176). CIED presence showed a nonsignificant association with more adverse outcomes (HR: 1.31; 95% CI: 0.99-1.74; P = 0.063) but was not associated with residual TR >2+ (OR: 0.98; 95% CI: 0.70-1.38; P = 0.915). Achieving residual TR ≤2+ conferred significantly better survival irrespective of CIED presence (P < 0.001).
CONCLUSIONS: T-TEER is safe and effective in selected patients with transvalvular CIED leads. Effective TR reduction remains prognostically relevant, even in this high-risk real-world population.