Tricuspid transcatheter edge-to-edge repair (T-TEER) has emerged as a treatment option for patients with symptomatic tricuspid regurgitation (TR). However, many patients with TR also have coexisting left-sided valvular heart disease (VHD), and the impact of this additional valvular burden on outcomes following T-TEER remains incompletely understood.

In a study in the ESC Heart Failure, investigators analyzed data from the European Registry of Transcatheter Repair for Tricuspid Regurgitation (EuroTR) to assess the prevalence and prognostic significance of concomitant left-sided VHD in patients undergoing T-TEER. The study included 1,647 patients with complete echocardiographic data on left-sided valve disease.

Findings

• Concomitant left-sided valvular disease was highly prevalent, with 35.6% of patients having moderate or greater VHD and 3.8% having severe VHD.
• Patients with moderate or greater left-sided VHD had significantly lower two-year survival compared with those without significant valve disease (P<0.001).
• Heart failure hospitalization-free survival at two years was significantly lower among patients with moderate or greater left-sided VHD (P=0.005).
• In multivariable analysis, moderate or greater left-sided VHD independently predicted mortality after T-TEER (HR, 1.54; 95% CI, 1.21–1.96; P<0.001).
• Despite having more severe TR and worse NYHA functional class at baseline, patients with moderate or greater VHD experienced significant reductions in TR severity and improvements in symptoms following T-TEER (both P<0.001).

The findings indicate that concomitant left-sided valvular heart disease is common among patients undergoing T-TEER and is associated with poorer long-term outcomes, including higher mortality and heart failure hospitalization rates.