Outcome of transcatheter tricuspid valve interventions in patients with previous left valvular heart interventions

M. N. Alachkar (Bernau bei Berlin)¹, J. Schlegl (Bernau bei Berlin)¹, M. Bannehr (Bernau bei Berlin)¹, T. Kücken (Bernau bei Berlin)¹, M. Neuß (Bernau bei Berlin)¹, A. Haase-Fielitz (Bernau bei Berlin)¹, C. Edlinger (Bernau bei Berlin)¹, C. Butter (Bernau bei Berlin)^1
1Immanuel Klinikum Bernau Herzzentrum Brandenburg / Kardiologie Bernau bei Berlin, Deutschland

Background:
A substantial proportion of patients referred for transcatheter tricuspid valve intervention (TTVI) have a history of prior left-sided valve intervention (PLVI). However, the impact of PLVI on procedural and clinical outcomes after TTVI has not yet been investigated.

Method and results:
We prospectively enrolled 113 consecutive patients undergoing TTVI at our centre. Patients were stratified according to the presence of prior left-sided valve intervention (PLVI vs. non-PLVI). The primary endpoint was the composite of all-cause mortality or heart failure hospitalization at one year.
Overall, 33 patients (29.2%) had PLVI, including prior surgical aortic valve intervention (9/33; 27.3%), surgical mitral valve intervention (14/33; 42.4%), transcatheter aortic valve implantation (7/33; 21.2%), and mitral transcatheter edge-to-edge repair (3/33; 9.1%). EuroScore II tended to be higher in patients with PLVI, whereas other baseline clinical and echocardiographic characteristics were comparable. TTVI procedures included transcatheter tricuspid edge-to-edge repair (69%), TricValve implantation (20.4%), and Evoque implantation (10.6%), without differences between patients with and without PLVI (p=0.92). At one year, the combined endpoint of mortality or heart failure hospitalization was numerically higher but did not differ significantly between groups in patients with PLVI, (45.5% in the PLVI group vs. 37.5% in the non-PLVI group, HR 1.18, 95% CI 0.64-2.19, p=0.59). After exclusion of patients treated with TricValve, residual TR ≤ moderate at one year was achieved in 56% of patients with PLVI and 60% of patients without PLVI (OR 0.85, 95% CI 0.28–2.54; p=0.77).

Conclusion:
Patients with PLVI represent about one third of patients undergoing TTVI. Despite a history of prior left-sided valve intervention, patients achieved similar procedural and clinical outcomes following TTVI.

Anmerkung: Aus Platzgründen werden die vollständigen Tabellen mit Basischarakteristika und Outcome-Daten in der Poster/ Freier Vortrag präsentation gezeigt.