Introduction: Tricuspid valve regurgitation (TR) is more prevalent among females. Transcatheter tricuspid valve repair (TTVR) using the Edge-To-Edge technique represents an alternative to surgery in patients with high surgical risk. This study aims to investigate gender differences among patients undergoing TTVR.
Methods: All patients who underwent TTVR till 03/2023 at our center were retrospectively included. We compared the intra-hospital outcome and one-year outcome between males and females.
Results: 105 consecutive patients underwent TTVR. Females were more prevalent in the study cohort (n=63, 60%). Age was comparable between males and females (80.7±7.4 vs. 80.3±5.8, p=0.622). Coronary artery disease was more evident in males than females (71.4 vs. 47.6, p=0.016). LV-EF was worse in males than in females (48.8±13.4 vs. 58 ±6.8, p< 0,001). Other clinical characteristics were similar between both groups. Success of the procedure (88.1% vs. 95.2%, p=0.177) and intra-hospital mortality (4.8% vs. 11.1%, p=0.255) were similar among males and females. At one year follow-up, mortality was similar among both groups (24.3% vs. 25.9%, p=0.863). Furthermore, hospitalization due to acute heart failure was also similar between both groups (40.5% vs. 37.5%, p=0.768) as well as a composite endpoint of death or hospitalization (table 1, figure 1). In patients with successful procedures and who survived one year TR severity was comparable among both groups (Figure 2).
Conclusion: In our retrospective observational study, no difference was observed in outcome among males and females undergoing TTVR at one-year follow-up.
Table 1. Intrahospital and one- year outcome
|
|
Intra hospital outcome (N=105)
|
|
|
All
(N=105)
|
Male
(N=42)
|
Female
(N=63)
|
p-value
|
|
Success of the procedure
|
97 (92.4%)
|
37 (88.1%)
|
60 (95.2%)
|
0.177
|
|
Number of clips, n (%)
|
|
|
|
0.151
|
|
1
|
56 (53.3)
|
38 (60.3)
|
18 (42.9)
|
|
|
2
|
40 (38.1)
|
20 (47.6)
|
20 (31.7)
|
|
|
3
|
2 (1.9)
|
0
|
2 (3.2)
|
|
|
Position of clip
|
|
|
|
0.794
|
|
Antero-septal
|
68 (64.8)
|
27 (64.3)
|
41 (65.1)
|
|
|
Postero-septal
|
17 (16.2)
|
6 (14.3)
|
11 (17.5)
|
|
|
Both
|
13 (12.4)
|
5 (11.9)
|
8 (12.7)
|
|
|
Pmean, mmHG
|
2.8±1.3
|
2.7±1.2
|
2.9±1.3
|
0.506
|
|
|
|
|
|
|
|
Vascular complications, n (%)
|
10 (9.5)
|
2 (4.8)
|
8 (12.7)
|
0.175
|
|
Intrahospital mortality, n (%)
|
9 (8.6)
|
2 (4.8)
|
7 (11.1)
|
0.255
|
|
|
|
|
|
|
|
TR severity
|
|
|
|
0.168
|
|
I
|
51 (48.6)
|
23 (54.8)
|
28 (44.4)
|
|
|
II
|
43 (41)
|
14 (33.3)
|
29 (46.0)
|
|
|
III
|
6 (5.7)
|
1(2.4)
|
5 (7.9)
|
|
|
IV
|
4 (3.8)
|
3 (7.1)
|
1 (1.6)
|
|
|
V
|
1 (1)
|
1 (2.4)
|
0 (0)
|
|
|
|
One year outcome (N=91)┼
|
|
|
All
(N=91)
|
Male
(N= 37)
|
Female
(N=54)
|
p-value
|
|
Mortality at one year (n,%)
|
23 (25.3)
|
9 (24.3)
|
14 (25.9)
|
0.863
|
|
HF hospitalisation (n, %)
|
36 (38.7)
|
15 (40.5)
|
21 (37.5)
|
0.768
|
Figure 1. Comparison of one year outcome between males und females
Figure 2. Comparison severity of TR at 1-year follow up between males and females#.
# Included patients who had a successful procedure and who survived at one year
