{"id":"019521d90f4a","type":"article","url":"https://hartvaat.nl/2026/04/24/gecombineerde-mitraal-en-tricuspidalis-teer-verbetert-overleving-bij-multivalvul/","title":"Gecombineerde mitraal- en tricuspidalis-TEER verbetert overleving bij multivalvulair lijden","title_en":"","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":["tricuspidalisinsufficiëntie"],"journal":"European heart journal","doi":"10.1093/eurheartj/ehag186","source_url":"https://doi.org/10.1093/eurheartj/ehag186","authors":["Mohammad Kassar","Fabien Praz","Muhammed Gerçek","Vera Fortmeier","Karl-Patrik Kresoja","Jennifer von Stein","Christoph Pauschinger","Wolfgang Rottbauer","Bjoern Goebel","Paolo Denti","Paul Achouh","Tienush Rassaf","Manuel Barreiro-Perez","Peter Boekstegers","Andreas Rück","Monika Zdanyte","Marianna Adamo","Flavien Vincent","Philipp Schlegel","Sebastian Rosch","Mirjam G Wild","Christian Besler","Stefan Toggweiler","Stephanie Brunner","Julia Grapsa","Tiffany Patterson","Holger Thiele","Tobias Kister","Giuseppe Tarantini","Giulia Masiero","Marco De Carlo","Alessandro Sticchi","Fabian Voss","Amin Polzin","Antonio Popolo Rubbio","Francesco Bedogni","Mathias H Konstandin","Eric Van Belle","Marco Metra","Tobias Geisler","Rodrigo Estévez-Loureiro","Amir Mahabadi","Nicole Karam","Francesco Maisano","Philipp Lauten","Mirjam Kessler","Daniel Kalbacher","Christos Iliadis","Philipp Lurz","Jörg Hausleiter","Felix Mahfoud","Stephan Windecker","Lukas Stolz","Nicolas Brugger","Volker Rudolph"],"significance":8,"published":"2026-05-07","source_date":"2026-04-24","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/stemi/","https://hartvaat.nl/kennis/vasculair/wells-score-dvt-longembolie/"],"congress":"","summary_en":"In the EuroTR registry of 3,100 patients with severe tricuspid regurgitation, 30% also had moderate mitral regurgitation — associated with higher 2-year mortality (37% vs 23%). After propensity score matching (217 pairs), concomitant mitral TEER added to tricuspid TEER produced greater TR reduction, better NYHA class and 6-minute walk distance, and significantly higher survival (87% vs 76% at 1 year; 81% vs 70% at 2 years). On multivariable analysis, moderate MR predicted death (HR 1.81) and combined M-TEER predicted survival (HR 0.46). Hypothesis-generating — a dedicated RCT is needed.","created":"2026-07-03T10:32:51Z","updated":"2026-07-03T13:31:47Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"In het EuroTR-register (3100 patiënten met ernstige tricuspidalisinsufficiëntie) had 30% tegelijk matige mitraalinsufficiëntie, geassocieerd met hogere 2-jaarssterfte (37% vs 23%). Na propensity score matching (217 paren) liet gelijktijdige mitraal-TEER bovenop tricuspidalis-TEER een grotere TI-reductie zien, betere NYHA-klasse en 6-minutenwandeltest, en significant hogere overleving (87% vs 76% op 1 jaar; 81% vs 70% op 2 jaar). Multivariabele analyse: matige MI voorspelde meer mortaliteit (HR 1,81), gecombineerde M-TEER voorspelde overleving (HR 0,46). Hypothesegenererend; bevestiging in een gerandomiseerde studie is nodig.","abstract_original":"BACKGROUND AND AIMS: The coexistence of moderate mitral regurgitation (MR) and severe tricuspid regurgitation (TR) is common, yet evidence guiding optimal management remains limited. Transcatheter edge-to-edge repair (TEER) of both valves-performed either sequentially or in combination-has emerged as a potential therapeutic strategy. This study aimed to assess the prognostic impact of moderate MR in patients undergoing tricuspid TEER (T-TEER) for severe TR and to evaluate whether concomitant mitral TEER (M-TEER) improves clinical outcomes. METHODS: Data from the EuroTR registry (2016-25) were analysed, including patients with severe TR treated with T-TEER. Outcomes were compared between patients with untreated moderate MR and those who underwent concomitant M-TEER using propensity score matching (PSM). The primary endpoint was all-cause mortality at 2 years. Secondary endpoints included New York Heart Association (NYHA) class, 6 min walk distance (6MWD), TR severity, and heart failure rehospitalizations. RESULTS: Among 3100 patients, 30% had moderate MR, which was associated with higher 2-year mortality (23% vs 37%, p<0.0001). After PSM, 217 matched patients treated with concomitant M-TEER had greater TR reduction (-1.9 vs -1.6 grades, P = .001), better NYHA improvement, and increased 6MWD at follow-up. Survival was higher in the combined treatment group (87% vs 76% at 1 year; 81% vs 70% at 2 years, P = .005). In a multivariable analysis, moderate MR predicted increased mortality [hazard ratio (HR) 1.81, P = .005), while combined M-TEER predicted better survival (HR 0.46, P < .0001). CONCLUSIONS: Moderate MR predicts impaired prognosis in patients undergoing T-TEER for treatment of severe TR. Concomitant M-TEER is associated with improved survival and functional outcomes in this population with multivalve disease. These findings are hypothesis-generating and need to be tested in a dedicated randomized controlled trial."}