Giulio Russo, Daniela Pedicino, Marianna Adamo, Hannes Alessandrini, Martin Andreas, Daniel Braun, Kim A. Connelly, Paolo Denti, Rodrigo Estevez-Loureiro, Neil Fam, Rebecca T. Hahn, Claudia Harr, Jöerg Hausleiter, Daniel Kalbacher, Edwin Ho, Azeem Latib, Edith Lubos, S Ludwig, P H I L I P Lurz, Marco Metra, Vanessa Moñivas, Georg Nickenig, Giovanni Pedrazzini, Alberto Pozzoli, Fabien Praz, Josep Rodes-Cabau, Christian Besler, K P Rommel, Joachim Schofer, A Scotti, Nicolò Lentini, R Pastorino, Kerstin Piayda, Horst Sievert, Gilbert H.L. Tang, Isaac Pascual, Holger Thiele, Florian Schlotter, Giuseppe Massimo Sangiorgi, Ralph Stephan von Bardeleben, J.A.W. Webb, S W Windecker, M.B. Leon, Maurice Enriquez-Sarano, Francesco Maisano, Stefan Bloechlinger, Maurizio Taramasso
BACKGROUND: The impact of proportionality to heart valve regurgitation has been widely investigated in mitral regurgitation, helping to better characterize the best candidates for therapies. However, it has never been studied in tricuspid regurgitation (TR). The aim of the present study is to investigate the impact of the proportionality of TR on outcomes. METHODS: Patients undergoing tricuspid transcatheter edge-to-edge repair were selected from the TRIVALVE registry (International Multisite Transcatheter Tricuspid Valve Therapies Registry). Patients were divided according to the ratio between effective regurgitant orifice area (EROA) and right ventricular (RV) end diastolic diameter (RVEDD) into tertiles: patients with low EROA/RVEDD (RV, dominant); intermediate EROA/RVEDD (RV and TR, RV-TR, codominant), and high EROA/RVEDD (TR, dominant). The primary outcome was all-cause mortality. Median follow-up was 9.7 months (4.2-12.0). RESULTS: A total of 204 patients were included in the present study: 67 for the RV dominant, 68 for the RV-TR codominant, and 69 for the TR dominant group. The 3 groups presented different baseline characteristics. Survival analysis among the 3 groups showed a trend towards worse prognosis for the RV-dominant group, as compared with the RV-TR codominant and TR dominant groups. CONCLUSIONS: The conceptual framework of proportionality is applicable to TR with EROA/RVEDD, defining a higher risk RV-dominant phenotype with a trend towards worse survival after tricuspid transcatheter edge-to-edge repair.