Midterm analysis of tricuspid regurgitation in patients undergoing transcatheter mitral valve-in-valve replacement: A retrospective study

经导管二尖瓣置换术患者三尖瓣反流的中期分析:一项回顾性研究

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Abstract

OBJECTIVE: The evolution of concomitant tricuspid regurgitation (TR) after transcatheter mitral valve-in-valve replacement (TM-ViV) is poorly characterized. Therefore, we aimed to analyze the midterm changes in TR following TM-ViV at our center. METHODS: Clinical data of patients who underwent TM-ViV at Guangdong Provincial People's Hospital was retrospectively analyzed. In total, 96 patients underwent TM-ViV between April 2020 and October 2023. RESULTS: Preoperatively, 26 patients had mild or less TR (none/mild TR group), whereas 70 patients had moderate or more TR (moderate/severe TR group). The mean follow-up time was 32.4 ± 11.8 months, and the proportion of patients with moderate/severe TR at 1 month and 1 year postoperatively was significantly lower than the preoperative value (1 month: 47.3% vs 72.9%; P < .001; 1 year: 50.0% vs 72.9%; P = .001). No significant difference in midterm mortality outcomes was observed between the 2 groups (P > .999). CONCLUSIONS: After TM-ViV surgery, the degree of TR decreased in a majority of patients who had moderate or severe TR preoperatively at midterm follow-up. However, due to limited statistical power, our exploratory analysis could not establish an association between preoperative TR and midterm mortality. Therefore, the prognostic influence of TR severity in this setting remains uncertain and requires validation in future studies.

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