Tricuspid transcatheter edge-to-edge repair for tricuspid valve regurgitation: a sex-based real-world analysis from the TRI-SPA registry.
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Ruberti Andrea, Cepas-Guillen Pedro, Echarte-Morales Julio, Arzamendi Dabit, Moñivas Vanessa, Carrasco-Chinchilla Fernando, Pan Manuel, Nombela-Franco Luis, Pascual Isaac, Sabatè-Tenas Manel, Benito-González Tomás, Pérez Ruth, Gómez-Blázquez Iván, Amat-Santos Ignacio J, Flores-Umanzor Eduardo, Cruz-González Ignacio, Sánchez-Recalde Ángel, Cid Álvarez Ana Belén, Barreiro-Pérez Manuel, Sanchis Laura, Li Chi-Hion, Caneiro-Queija Berenice, Del Trigo María, Martínez-Carmona José David, Mesa-Rubio Dolores, Jiménez Pilar, Avanzas Pablo, Estévez-Loureiro Rodrigo, Freixa Xavier
Аннотация
METHODS AND RESULTS: This sub-analysis of the Transcatheter tRicuspid valve repaIr in SPAin (TRI-SPA) registry includes patients who underwent T-TEER for severe TR between June 2020 and May 2023 in Spain. Outcomes were compared by sex. The primary composite endpoint included all-cause mortality, heart failure-related hospitalization, and tricuspid valve re-intervention at 12 months. Secondary endpoints included significant TR recurrence and functional improvement. Among 310 patients (mean age 75.5 ± 9.1 years) with severe TR treated with T-TEER, 70% were females. Males exhibited more prevalent coronary artery disease (30.4 vs. 12.8%; p < 0.001) and reduced right ventricular (RV) function compared with females (RV fractional area change 34.5 vs. 42.0%; p < 0.001). Women had larger left atrial volume (45.7 vs. 40.8 mL/m², p = 0.038). Procedural success was high and comparable among sexes (90.7 vs. 89.3% in females and males, respectively; p = 0.71). No significant difference emerged in relation to the primary composite endpoint (absolute event rate in males 27.5 vs. 16.3% in females; adjusted HR 0.61, 95% CI: 0.31-1.18; p = 0.142). At 12 months, comparable sustained TR reduction (grade ≤2+) rates (67.3% in males vs. 73.5% in females; p = 0.40) and functional improvement (NYHA I/II class 75.0 vs. 82.3%; p = 0.78) were observed.
CONCLUSION: In a real-world setting, T-TEER was equally safe and effective in both sexes, achieving comparable procedural success and durable TR reduction.