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

Autor: Meijerink F; Department of Cardiology, Amsterdam UMC, location AMC, Amsterdam, The Netherlands., Koch KT; Department of Cardiology, Amsterdam UMC, location AMC, Amsterdam, The Netherlands., de Winter RJ; Department of Cardiology, Amsterdam UMC, location AMC, Amsterdam, The Netherlands., Robbers-Visser D; Department of Cardiology, Amsterdam UMC, location AMC, Amsterdam, The Netherlands., Boekholdt SM; Department of Cardiology, Amsterdam UMC, location AMC, Amsterdam, The Netherlands., Holierook M; Department of Cardiology, Amsterdam UMC, location AMC, Amsterdam, The Netherlands., Baan J; Department of Cardiology, Amsterdam UMC, location AMC, Amsterdam, The Netherlands., Bouma BJ; Department of Cardiology, Amsterdam UMC, location AMC, Amsterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions [Catheter Cardiovasc Interv] 2021 Sep; Vol. 98 (3), pp. E427-E435. Date of Electronic Publication: 2021 Jan 18.
DOI: 10.1002/ccd.29464
Abstrakt: Objectives: The aim of this study was to determine the course of tricuspid regurgitation (TR) after transcatheter mitral valve repair (TMVR), identify predictors for severe TR after TMVR and determine the association of severe TR after TMVR with outcome.
Background: TR is often present in patients with symptomatic mitral regurgitation (MR) and is associated with increased morbidity and mortality. The clinical course of TR after TMVR has not been clearly determined.
Methods: Patients that underwent TMVR between 2009 and 2017 were included. Clinical data were compared between patients with and without severe TR at 6 months after TMVR. Multivariate logistic regression analysis was performed to identify predictors for severe TR after TMVR. Survival analysis was done for both groups, using the Kaplan-Meier method.
Results: A total of 146 patients were included (mean age 76 years, 51% male, 79% New York Heart Association class ≥3 and 29% severe TR at baseline). Advanced age, atrial fibrillation (AF), right ventricular (RV) dysfunction, and limited procedural MR reduction were revealed as independent predictors for severe TR after TMVR. Survival of patients with severe TR after TMVR was 58% after 2 years compared to 82% for those with non, mild or moderate TR.
Conclusions: Severe TR after TMVR is common in patients at advanced age, those with AF, RV dysfunction and limited MR reduction during TMVR and is associated with impaired survival. As the associated parameters are indicators of longstanding MR, research investigating the benefits of earlier intervention in MR should be initiated.
(© 2021 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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