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Background <p>Data on the association of previous cardiac surgery (PCS) with outcomes following tricuspid valve transcatheter edge-to-edge repair (T-TEER) are limited.</p> Objectives <p>This study aimed to evaluate the impact of PCS on outcomes after T-TEER.</p> Methods <p>This analysis included patients from the EuroTR registry (European Registry of Transcatheter Repair for Tricuspid Regurgitation; NCT0630726) who underwent T-TEER for clinically relevant tricuspid regurgitation (TR) between 2016 and 2024 and had available information on cardiac surgical history. Study endpoints were procedural TR reduction, improvement in NYHA functional class, all-cause mortality, and the composite of death or heart failure hospitalization (HFH) at 2&#xa0;years.</p> Results <p>Among 2929 patients, 27.2% had a history of PCS. These patients exhibited a higher comorbidity burden and more advanced right heart remodeling. TR severity at baseline was comparable between groups (<i>P</i> = 0.095), whereas residual TR at discharge and follow-up was higher in patients with PCS (both <i>P</i> &lt; 0.001). PCS independently predicted residual TR ≥ 3 + at discharge (OR: 1.41; 95% CI: 1.11–1.79; <i>P</i> = 0.01). T-TEER was associated with an improvement in NYHA class in patients with and without PCS (≥ 1-class reduction: 66.2% in PCS vs. 59.6% in non-PCS patients; <i>P</i> = 0.15). At 2&#xa0;years, PCS patients had higher all-cause mortality (HR: 1.25; 95% CI: 1.04–1.50; <i>P</i> = 0.02) and a higher incidence of the composite endpoint of death or HFH (HR: 1.24; 95% CI: 1.05–1.46; <i>P</i> = 0.01).</p> Conclusions <p>PCS is an independent predictor of outcomes in patients undergoing T-TEER, identifying a subgroup with less pronounced TR reduction and lower long-term survival despite significant functional improvement.</p> Graphical Abstract <p></p>

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Impact of Previous Cardiac Surgery on Outcomes After Tricuspid Valve Transcatheter Edge-to-Edge Repair: Insights from EuroTR 

  • 期刊论文

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  • 发表日期：

    2026年5月18日

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  • Dario Grassini,
  • Karl-Patrik Kresoja,
  • Jennifer von Stein,
  • Vera Fortmeier,
  • Christoph Pauschinger,
  • Wolfgang Rottbauer,
  • Mohammad Kassar,
  • Bjoern Goebel,
  • Paolo Denti,
  • Paul Achouh,
  • Tienush Rassaf,
  • Manuel Barreiro-Perez,
  • Peter Boekstegers,
  • Andreas Rück,
  • Monika Zdanyte,
  • Marianna Adamo,
  • Flavien Vincent,
  • Philipp Schlegel,
  • Sebastian Rosch,
  • Mirjam G. Wild,
  • Christian Besler,
  • Stefan Toggweiler,
  • Stephanie Brunner,
  • Julia Grapsa,
  • Tiffany Patterson,
  • Holger Thiele,
  • Tobias Kister,
  • Giuseppe Tarantini,
  • Giulia Masiero,
  • Marco De Carlo,
  • Cristina Giannini,
  • Fabian Voss,
  • Amin Polzin,
  • Antonio Popolo Rubbio,
  • Francesco Bedogni,
  • Thorald Stolte,
  • Thomas Nestelberger,
  • Tomás Benito-González,
  • Enrique Sánchez-Muñóz,
  • Martijn Vrijkorte,
  • Martin Swaans,
  • Mathias H. Konstandin,
  • Eric Van Belle,
  • Marco Metra,
  • Tobias Geisler,
  • Rodrigo Estévez-Loureiro,
  • Amir Abbas Mahabadi,
  • Nicole Karam,
  • Francesco Maisano,
  • Philipp Lauten,
  • Mirjam Kessler,
  • Daniel Kalbacher,
  • Volker Rudolph,
  • Christos Iliadis,
  • Philipp Lurz,
  • Fabien Praz,
  • Lukas Stolz,
  • Jörg Hausleiter,
  • Philipp Doldi,
  • Ludwig T. Weckbach,
  • Thomas J. Stocker,
  • Julia Novotny,
  • Kaspar Volz,
  • Katalin Berschiminski,
  • Hannah Kempton,
  • Karl-Philip Rommel,
  • Ralph Stephan von Bardeleben,
  • Roman Pfister,
  • Stephan Baldus,
  • Philipp von Stein,
  • Muhammed Gerçek,
  • Felix Rudolph,
  • Hazem Omran,
  • Sebastian Ludwig,
  • Benedikt Koell,
  • Leonhard-Moritz Schneider,
  • Dominik Felbel,
  • Carsten Salomon,
  • Harald Lapp,
  • Quentin de Baynast,
  • Alain Berrebi,
  • Florian Schindhelm,
  • Berenice Caneiro-Queija,
  • Julio Echarte-Morales,
  • Andreas Goldschmied,
  • Edoardo Pancaldi,
  • Elisa Pezzola,
  • Mauro Massussi,
  • Laura Lupi,
  • Natacha Rousse,
  • Samy Aghezzaf,
  • Norbert Frey,
  • Martin Kraus,
  • Dirk Westermann,
  • Federico Arturi,
  • Alessandro Sticchi,
  • Matteo Mazzola,
  • Anke von Peter

摘要

Background

Data on the association of previous cardiac surgery (PCS) with outcomes following tricuspid valve transcatheter edge-to-edge repair (T-TEER) are limited.

Objectives

This study aimed to evaluate the impact of PCS on outcomes after T-TEER.

Methods

This analysis included patients from the EuroTR registry (European Registry of Transcatheter Repair for Tricuspid Regurgitation; NCT0630726) who underwent T-TEER for clinically relevant tricuspid regurgitation (TR) between 2016 and 2024 and had available information on cardiac surgical history. Study endpoints were procedural TR reduction, improvement in NYHA functional class, all-cause mortality, and the composite of death or heart failure hospitalization (HFH) at 2 years.

Results

Among 2929 patients, 27.2% had a history of PCS. These patients exhibited a higher comorbidity burden and more advanced right heart remodeling. TR severity at baseline was comparable between groups (P = 0.095), whereas residual TR at discharge and follow-up was higher in patients with PCS (both P < 0.001). PCS independently predicted residual TR ≥ 3 + at discharge (OR: 1.41; 95% CI: 1.11–1.79; P = 0.01). T-TEER was associated with an improvement in NYHA class in patients with and without PCS (≥ 1-class reduction: 66.2% in PCS vs. 59.6% in non-PCS patients; P = 0.15). At 2 years, PCS patients had higher all-cause mortality (HR: 1.25; 95% CI: 1.04–1.50; P = 0.02) and a higher incidence of the composite endpoint of death or HFH (HR: 1.24; 95% CI: 1.05–1.46; P = 0.01).

Conclusions

PCS is an independent predictor of outcomes in patients undergoing T-TEER, identifying a subgroup with less pronounced TR reduction and lower long-term survival despite significant functional improvement.

Graphical Abstract