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1II. Medizinische Klinik - Kardiologie, Angiologie, Pneumologie, REGIOMED-KLINIKEN GmbH, Coburg; 2II. Medizinische Klinik - Kardiologie, Angiologie, REGIOMED-KLINIKEN GmbH, Coburg;
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Aim:
Symptomatic tricuspid regurgitation (TR) is associated with a high mortality rate and heart failure-related hospitalization. Symptomatic therapy remains weak in controlling severe TR with an elevated morbidity and mortality rate. We aimed to study gender-specific differences in patients who underwent transcatheter tricuspid valve repair procedures.
Materials & methods:
Patients with severe and symptomatic TR were presented and evaluated by the heart team. Patients with high surgical risks underwent transcatheter tricuspid valve repair procedures in our center. Post-procedural transthoracic echocardiography (TTE) technique was performed to determine the TR grade and exclude procedure-related complications.
A total of 50 (80.64 ±6.88, 19 Men and 31 Women) consecutive patients who underwent transcatheter tricuspid valve repair in our center between September 2021 and January 2022 were enrolled in this study. The baseline characteristics are presented in Table 1. No significant gender-specific differences were detected in the baseline characteristics. Patients enrolled were in a similar age category (Male 80.84 ± 8.6, Female 80.52 ± 5.7). No statistically significant differences in the tricuspid valve baseline echocardiographic characteristics between both genders was determined (Table 2). MitraClip (XT and XTW) systems were used for valve reparation in most cases. Procedural success, defined as reducing the TR to grade I-II, was achieved in 98% of the patients (3.76±0.625 vs. 1.26±0.443, P = 0.088). All patients improved in the New York Heart Association functional class 30 days after the intervention (2.88±0.521 vs. 1.36±0.568 p= 0.074). No procedure-related death was registered.
Conclusions
Our preliminary results indicate that transcatheter tricuspid valve repair is a safe and effective therapeutic option in patients with severe TR and high surgical risks. Our analysis shows an equal profit for the procedure for both genders. No gender-specific differences were detected.
Table 1
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|
Total (n = 50) |
Male (n = 19) |
Female (n = 31) |
p- Value |
|
Age, years |
80.64 ± 6.88 |
80.84 ± 8.6 |
80.52 ± 5.7 |
0.873 |
|
BMI, kg/ m² |
28.64 ± 5.07 |
20.08 ± 3.56 |
28.98 ± 5.84 |
0.548 |
|
CVD, n |
26 (52%) |
10 (52%) |
16 |
0.964 |
|
History of MI, n |
3 (6%) |
2 (10.5%) |
1 (3.2%) |
0.867 |
|
COPD, n |
10 (20%) |
3 (15.7%) |
7 (22.5%) |
0.569 |
|
Dialysis, n |
4 (8%) |
2 (10.5%) |
2 (6.45%) |
0.615 |
|
Diabetes, n |
9 (18%) |
2 (10.5%) |
7 (22.5%) |
0.291 |
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LVEF, % |
36.92 ± 24.11 |
40.59 ± 19.35 |
34.68 ± 26.66 |
0.406 |
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Mitral regurgitation |
1.42 ± 0.49 |
1.47 ± 0.51 |
1.39 ± 0.49 |
0.557 |
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Euroscore 2 |
21.19 ± 10.47 |
18.51 ± 12.71 |
22.83± 8.65 |
0.159 |
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STS Score |
7.71 ± 5.37 |
8.47 ± 5.0 |
7.25 ± 5.6 |
0.440 |
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Table 2
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Total (n = 50) |
Male (n = 19) |
Female (n = 31) |
p- Value |
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TR severity |
3.76 ± 0.625 |
3.84 ± 0.602 |
3.71 ± 0.643 |
0.473 |
|
TR etiology
Functional, n
Degenerative, n
Mixed, n
Other, n |
23 (46%)
12 (24%)
14 (18%)
1 (2%) |
9
4
5
1 |
14
8
9
0 |
0.834 |
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Duration of RV-Failure caused by TR, months |
11.82 ± 9.88 |
8.53 ± 5.09 |
13.84 ± 11.55 |
0.065 |
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NYHA class |
2.88 ± 0.52 |
2.84 ± 0,375 |
2,9 ± 0.59 |
0.691 |
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LVEDD, mm |
47.4 ± 13.8 |
52.32 ± 12.53 |
44.39 ± 13.86 |
0.047 |
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LA volume, ml |
44.98± 12.96 |
44.30 ± 14.7 |
45.39 ± 12.01 |
0.776 |
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TR main location
Central, n
Anteroseptal, n
Anteroposterior, n
Posteroseptal, n |
20 (40%)
23 (46%)
4 (8%)
3 (6%) |
6
8
4
1 |
14
12
3
2 |
0.062 |
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TAPSE, mm |
20.48 ± 4.83 |
19 ± 4.5 |
21.39 ± 4.8 |
0.09 |
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RVEDD, mm |
41.78 ± 7.6 |
42.37 ± 9.4 |
41.42 ± 6.3 |
0.673 |
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sPAP, mmHg |
48.26 ± 11.08 |
48.32 ± 9.08 |
48.23 ± 12.29 |
0.978 |
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