title: Tricuspid regurgitation is a predictor of mortality after percutaneous mitral valve edge-to-edge repair.
abstract: OBJECTIVE
  The aim of this study was to determine the impact of tricuspid regurgitation (TR) on mortality after edge-to-edge percutaneous mitral valve repair (PMVR), and also to analyse whether there is a difference in outcome between patients with improvement of TR after PMVR compared to patients without.
  
  
  RESULTS
  Out of 197 consecutive patients who underwent PMVR, 139 patients with available follow-up (mean 428±386 days) were included in the study. Concomitant moderate/severe TR was present in 58.3% of patients. Kaplan-Meier analysis showed significantly reduced overall survival for patients with moderate/severe TR, compared to patients with none/mild TR (p=0.003). Cox multivariate regression analysis revealed severe TR at baseline as the strongest independent predictor of mortality (HR 4.367, p=0.003). An improvement of the baseline moderate/severe TR was observed in 45.5% of patients at 30-day follow-up. Patients with no improvement of TR after PMVR had a higher midterm mortality compared to patients in whom TR improved (40.5% versus 11.4%, p=0.005).
  
  
  CONCLUSIONS
  More than half of patients undergoing PMVR have concomitant moderate/severe TR, which is associated with a worse outcome. Among predictors of mortality after edge-to-edge PMVR, severe TR at baseline is the most important. Patients with no improvement of TR at 30 days after PMVR have a significantly higher mortality at follow-up.
authors.affiliation: Medical Care Center Prof. Mathey, Prof. Schofer, Hamburg, Germany.
authors.forename: Ermela
authors.initials: E
authors.lastname: Yzeiraj
authors.forename: Klaudija
authors.initials: K
authors.lastname: Bijuklic
authors.forename: Claudia
authors.initials: C
authors.lastname: Tiburtius
authors.forename: Julian
authors.initials: J
authors.lastname: Witt
authors.forename: Korff
authors.initials: K
authors.lastname: Krause
authors.forename: Jana
authors.initials: J
authors.lastname: Steude
authors.forename: Lorenz
authors.initials: L
authors.lastname: Hansen
authors.forename: Friedrich-Christian
authors.initials: FC
authors.lastname: Rieß
authors.forename: Joachim
authors.initials: J
authors.lastname: Schofer
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006348:Cardiac Surgical Procedures / Q000379:methods; D005260:Female; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014261:Tricuspid Valve / Q000601:surgery*; D014262:Tricuspid Valve Insufficiency / Q000601:surgery*