Impact of tricuspid valve regurgitation in surgical high-risk patients undergoing MitraClip implantation: results from the TRAMI registry

Aims: We sought to assess the impact of tricuspid regurgitation (TR) severity on patient outcome in a collective with relevant mitral regurgitation undergoing MitraClip implantation. Methods and results: From August 2010 to July 2013, 766 patients (age 75.3±8.5 years, 61% male, median EuroSCORE 24.3...

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Hauptverfasser: Kalbacher, Daniel (VerfasserIn) , Bekeredjian, Raffi (VerfasserIn)
Dokumenttyp: Article (Journal)
Sprache:Englisch
Veröffentlicht: 03 February 2017
In: EuroIntervention
Year: 2017, Jahrgang: 12, Heft: 15, Pages: e1809-e1816
ISSN:1969-6213
DOI:10.4244/EIJ-D-16-00850
Online-Zugang:Verlag, kostenfrei, Volltext: http://dx.doi.org/10.4244/EIJ-D-16-00850
Verlag, kostenfrei, Volltext: https://www.pcronline.com/eurointervention/112th_issue/volume-12/number-15/295/impact-of-tricuspid-valve-regurgitation-in-surgical-high-risk-patients-undergoing-mitraclip-implantation-results-from-the-trami-registry.html
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Verfasserangaben:Daniel Kalbacher, Ulrich Schäfer, R. Stephan von Bardeleben, Christine S. Zuern, Raffi Bekeredjian, Taoufik Ouarrak, Horst Sievert, Georg Nickenig, Peter Boekstegers, Jochen Senges, Wolfgang Schillinger, Edith Lubos

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520 |a Aims: We sought to assess the impact of tricuspid regurgitation (TR) severity on patient outcome in a collective with relevant mitral regurgitation undergoing MitraClip implantation. Methods and results: From August 2010 to July 2013, 766 patients (age 75.3±8.5 years, 61% male, median EuroSCORE 24.3%±18.4) were prospectively enrolled in the TRAMI registry and stratified by echocardiography into no/mild, moderate and severe TR. Overall, the mean number of implanted MitraClips was higher in patients with severe TR but increasing TR severity was not associated with procedural success. In-hospital and one-year mortality as well as MACE and MACCE (death, myocardial infarction±stroke) rates were higher with increasing TR severity. Kaplan-Meier curves indicated a significant difference for mortality (p<0.0001), but not for rehospitalisation for heart failure. After multivariate Cox regression, severe TR proved to be a predictor for one-year mortality (HR 2.01, 95% CI: 1.25-3.26, p=0.004). Higher rates of severe bleeding were more frequent with increasing TR grades. Conclusions: In patients with MitraClip implantation, increasing TR severity is associated with adverse outcome, higher bleeding rates and decreased survival rates. 
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