Residual tricuspid regurgitation after tricuspid transcatheter edge‐to‐edge repair: Insights into the EuroTR registry

Aims Data on the prognostic impact of residual tricuspid regurgitation (TR) after tricuspid transcatheter edge‐to‐edge repair (T‐TEER) are scarce. The aim of this analysis was to evaluate 2‐year survival and symptomatic outcomes of patients in relation to residual TR after T‐TEER. Methods and results Using the large European Registry of Transcatheter Repair for Tricuspid Regurgitation (EuroTR registry) we investigated the impact of residual TR on 2‐year all‐cause mortality and New York Heart Association (NYHA) functional class at follow‐up. The study further identified predictors for residual TR ≥3+ using a logistic regression model. The study included a total of 1286 T‐TEER patients (mean age 78.0 ± 8.9 years, 53.6% female). TR was successfully reduced to ≤1+ in 42.4%, 2+ in 40.0% and 3+ in 14.9% of patients at discharge, while 2.8% remained with TR ≥4+ after the procedure. Residual TR ≥3+ was an independent multivariable predictor of 2‐year all‐cause mortality (hazard ratio 2.06, 95% confidence interval 1.30–3.26, p = 0.002). The prevalence of residual TR ≥3+ was four times higher in patients with higher baseline TR (vena contracta >11.1 mm) and more severe tricuspid valve tenting (tenting area >1.92 cm2). Of note, no survival difference was observed in patients with residual TR ≤1+ versus 2+ (76.2% vs. 73.1%, p = 0.461). The rate of NYHA functional class ≥III at follow‐up was significantly higher in patients with residual TR ≥3+ (52.4% vs. 40.5%, p