ISSN: 1885-5857 Impact factor 2023 7.2
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Efficacy of transcatheter edge-to-edge repair for cardiac implantable electronic device-associated tricuspid regurgitation: insights from the TRI-SPA registry

Eficacia de la reparación percutánea borde a borde para la insuficiencia tricuspídea en pacientes portadores de dispositivos cardiacos implantables: resultados del registro TRI-SPA

Andrea Rubertia2Pedro Cepas-Guillénab3Julio Echarte-MoralescdDabit ArzamendieVanessa MoñivasfFernando Carrasco-ChinchillagManuel PanhLuis Nombela-FrancoiIsaac PascualjClaudio E. GuerreirocdTomás Benito-GonzálezkRuth PérezlIván Gómez-BlázquezmIgnacio J. Amat-SantosnEduardo Flores-UmanzorabIgnacio Cruz-GonzálezopÁngel Sánchez-RecaldeqAna Belén Cid ÁlvarezrManuel Barreiro-PérezcdLaura Sanchisab4Chi-Hion LieBerenice Caneiro-QueijacdMaría del TrigofJosé David Martínez-CarmonagsDolores MesahPilar Jiménez QuevedoiPablo AvanzasjtuRodrigo Estévez-LoureirocdXavier Freixaab1&#¿;
https://doi.org/10.1016/j.rec.2025.01.010
La versión en español de este artículo estará disponible en breve

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Abstract

Introduction and objectives: This study aimed to assess the effectiveness and clinical outcomes of tricuspid transcatheter edge-to-edge repair (T-TEER) in patients with cardiac implantable electronic devices (CIEDs).

Methods: This subanalysis of the Transcatheter Tricuspid Valve Repair in Spain (TRI-SPA) registry included patients with at least severe tricuspid regurgitation (TR) who were treated with T-TEER between June 2020 and May 2023 in Spain. Patients with CIEDs and no or mild tricuspid lead-leaflet interaction were compared with those without CIEDs. The primary composite endpoint was all-cause mortality, heart failure-related hospitalization, and tricuspid valve reintervention at 12 months.

Results: Among 310 patients (mean age 75.5 ± 9.1 years, 70% female) with significant TR treated with T-TEER, 35 (11%) had CIEDs. Device implantation success was high in both groups (97.1% in the CIED group vs 96.4% in the non-CIED group, P = .81), with a similar rate of ≤ 2+ residual TR (84.9% in the CIED group vs 91.0% in the non-CIED group, P = .26). Patients with CIEDs experienced comparable rates of the primary composite endpoint to the non-CIED group (23.8% vs 19.1%, respectively, HR, 1.40; 95%CI, 0.60-3.31; P = .44), sustained successful TR reduction (≤ 2+ in 55.0% vs 73.8%, P = .07), and functional improvement (NYHA class I/II 81.8% vs 79.9%, P = .79).

Conclusions: In a real-world setting, T-TEER seems to be an effective therapeutic option for selected patients with more than moderate TR and CIEDs with no or mild lead-leaflet interaction, offering comparable cardiovascular outcomes and clinical improvement to those without leads. However, the presence of CIEDs may represent an independent risk factor for TR recurrence.

Keywords

Tricuspid regurgitation
Tricuspid transcatheter edge-to-edge repair
Cardiac implantable electronic devices
Atrial fibrillation

Abbreviations

CIED
RV
TR
TEER
T-TEER
TV

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