# EuroTR-register: co-existente linkszijdige kleplek verhoogt sterfte na transcatheter-tricuspidalis-edge-to-edge repair

*geplaatst 2026-06-27 · Hartfalen · ESC heart failure · doi 10.1093/eschf/xvag103 · https://hartvaat.nl/2026/05/05/eurotr-register-co-existente-linkszijdige-kleplek-verhoogt-sterfte-na-transcathe/*

Analyse van het European Registry of Transcatheter Repair for Tricuspid Regurgitation (EuroTR) bij 1.647 patiënten die T-TEER ondergingen voor tricuspidalisinsufficiëntie. Linkszijdige klepafwijking (VHD) van ≥mild kwam voor bij 95,8%, ≥matig bij 35,6% en ernstig bij 3,8%. ≥matige VHD was geassocieerd met significant lagere 2-jaars overleving (p<0,001) en lagere HF-opname-vrije overleving (p=0,005). Multivariate analyse bevestigde ≥matige VHD als onafhankelijke voorspeller van mortaliteit (HR 1,54; 95%-BI 1,21-1,96; p<0,001). Ondanks slechtere baseline-TR en NYHA bij ≥matige VHD bracht T-TEER bij beide groepen significante TR-reductie en symptomatische verbetering. Conclusie: bij T-TEER moet linkszijdige kleplekkage worden meegewogen voor prognose, terwijl symptomatische winst meestal behouden blijft.

## English: 

Analysis of the European Registry of Transcatheter Repair for Tricuspid Regurgitation (EuroTR) in 1,647 patients undergoing T-TEER. Concomitant left-sided valve disease (VHD) ≥mild was present in 95.8%, ≥moderate in 35.6%, and severe in 3.8%. ≥moderate VHD was associated with significantly lower 2-year survival (p<0.001) and HF-hospitalisation-free survival (p=0.005). Multivariable analysis confirmed ≥moderate VHD as an independent mortality predictor (HR 1.54; 95% CI 1.21-1.96; p<0.001). Despite worse baseline TR and NYHA in patients with ≥moderate VHD, T-TEER delivered significant TR reduction and symptomatic improvement in both groups. Conclusion: left-sided valvular disease should be weighed in the prognosis of T-TEER candidates, while symptomatic benefit is generally preserved.

## Abstract (original, from the publication)

INTRODUCTION: The impact of coexisting left-sided valvular heart disease (VHD) on clinical outcomes following tricuspid valve edge-to-edge repair (T-TEER) for tricuspid regurgitation (TR) remains unclear, particularly under real-world conditions. To evaluate the prevalence and prognostic impact of concomitant left-sided VHD in patients undergoing T-TEER. METHODS: This study included all patients undergoing T-TEER from the European Registry of Transcatheter Repair for Tricuspid Regurgitation (EuroTR; NCT06307262) with complete echocardiographic data on left-sided valve disease. Study endpoints included survival and heart failure hospitalizations (HFH) at 2 years, NYHA functional class, and TR reduction. RESULTS: Among a total of 1647 eligible patients, 95.8%, 35.6%, and 3.8% had ≥mild, moderate, and severe concomitant VHD, respectively. Moderate or higher VHD was associated with a significantly reduced 2-year survival (P < .001) and reduced 2-year HFH-free survival (P = .005). Multivariate regression analysis confirmed ≥ moderate VHD to be an independent predictor of mortality (hazard ratio 1.54, 95% CI 1.21-1.96, P < .001). Despite worse TR and NYHA functional class at baseline in patients with ≥moderate VHD, T-TEER was associated with a significant TR reduction (P < .001) and symptomatic improvement (P < .001). CONCLUSION: Concomitant left-sided VHD is common among patients undergoing T-TEER and is independently associated with worse survival and higher rates of HFH. Nevertheless, T-TEER provides meaningful symptomatic benefit and durable TR reduction in patients with and without VHD burden.

Auteurs: Jonas Gmeiner, Lukas Stolz, Karl-Patrik Kresoja, Jennifer von Stein, Vera Fortmeier, Christoph Pauschinger, Wolfgang Rottbauer, Mohammad Kassar, 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, Thorald Stolte, Thomas Nestelberger, Thomas Benito-Gonzales, Enrique Sánchez-Muñóz, Mathias H Konstandin, Eric Van Belle, Marco Metra, Tobias Geisler, Rodrigo Estévez-Loureiro, Amir Abbas Mahabadi, Nicole Karam, Francesco Maisano, Philipp Lauten, Fabien Praz, Mirjam Kessler, Daniel Kalbacher, Volker Rudolph, Christos Iliadis, Philipp Lurz, Jörg Hausleiter

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Bron: ESC heart failure, https://doi.org/10.1093/eschf/xvag103. Bijgewerkt 2026-08-10T11:07:51Z. 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.