Background: After percutaneous mitral-valve edge-to-edge repair (MVER) for mitral regurgitation (MR) in patients with baseline tricuspid regurgitation (TR), about one third of patients shows improvement in TR severity. It is unknown whether this improvement may depend on the presence of a right ventricular (RV) CIED lead.

Aim: We investigated whether the presence of an existing RV CIED lead influences TR severity after successful MVER due to symptomatic secondary MR.

Methods and Results: We retrospectively analyzed 115 consecutive patients with symptomatic secondary high-grade MR (age 78.1 ± 9.4 years, 50 women (43%) and baseline TR grade >1 (semiquantitative grading from 0 to 5) treated with MVER using the MitraClip^TM device (Abbott Cardiovascular, USA) and separated them in 2 groups: 43 patients with a CIED lead compared to 72 pts without (see Table). TR grading by echocardiography was performed before and 3 months after MVER (Mean follow up duration was 3 months). Procedural success with reduction of MR to <2/4 grades was 100% in both groups (p <0.001 vs. baseline). There was an overall significant change in TR grade after MVER in 46 pts (p=0.032). However, both increase in TR in 17 pts (16,7%, p=0.32), in 7 pts with and in 10 pts without CIED lead (58.8% vs. 41.2%, respectively; p=0.84) was not significant as well as decrease in TR in 29 patients (28.4%, p=0.24), in 9 pts with and in 20 pts without CIED lead (31% and 69%, respectively; p=0.47). TR reduction was associated with RV dilatation at baseline (p=0.027) but not the presence of pulmonary hypertension (p=0.83).

Conclusion: There was an overall significant change in TR after successful MVER. Although there was a trend towards an increase in TR after MVER in pts with CIED lead there was no overall significant correlation between changes in TR severity and the presence of an RV CIED lead but rather with baseline RV dilatation.