Valvular & structural heart disease
Prognostic Impact of Discharge Transprosthetic Tricuspid Gradient After Transcatheter Tricuspid Valve Replacement: The TRIPLACE Registry
Authors' conclusion
Elevated dTVG after TTVR independently identifies patients at increased risk of adverse outcomes. A 3.5 mm Hg threshold may support postprocedural risk stratification, whereas inner valve diameter represents a potentially modifiable determinant of elevated dTVG. (TRIPLACE [Global Multicenter Registry on Transcatheter Tricuspid Valve Replacement]; NCT06033274).
Study context
- Population
- Patients after transcatheter tricuspid valve replacement (TTVR), excluding those with in-hospital mortality, lack of TTVR technical success, missing dTVG, or unavailable follow-upincluded among 526 patients
- Participants
- 474 patients
- Exposure
- dTVG ≥3.5 mm Hg vs lower dTVG
- dTVG ≥3.5 mm Hgn = 122
- Outcome
- All-cause mortality
- Follow-up
- 1 and 3 years
Methodological detailsdischarge landmark analysis
- Discharge landmark analysis
Main finding
As reported in the abstract
dTVG ≥3.5 mm Hg vs dTVG <3.5 mm HgEstimate (95% CI)P value
1 year
HR 2.07(1.14–3.75)
P = 0.0173 years
HR 2.07(1.24–3.48)
P = 0.0063 years, multivariable adjustment
adjusted HR 1.84(1.09–3.10)
P = 0.022Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| Composite of all-cause mortality or heart failure hospitalization · 1 and 3 yearsdTVG ≥3.5 mm Hg vs dTVG <3.5 mm Hg · 1 year | HR 1.99 (95% CI 1.31–3.03) | P = 0.001 | |
| Composite of all-cause mortality or heart failure hospitalization · 1 and 3 yearsdTVG ≥3.5 mm Hg vs dTVG <3.5 mm Hg · 3 years | HR 1.96 (95% CI 1.33–2.88) | P < 0.001 | |
| Composite of all-cause mortality or heart failure hospitalization · 1 and 3 yearsdTVG ≥3.5 mm Hg vs dTVG <3.5 mm Hg · 1 year, multivariable adjustment | adjusted HR 1.77 (95% CI 1.16–2.70) | P = 0.009 | |
| Composite of all-cause mortality or heart failure hospitalization · 1 and 3 yearsdTVG ≥3.5 mm Hg vs dTVG <3.5 mm Hg · 3 years, multivariable adjustment | adjusted HR 1.77 (95% CI 1.20–2.60) | P = 0.004 | |
| Predictor of high dTVG: indexed inner transcatheter tricuspid valve diameterOnly potentially modifiable independent predictor | OR 0.79 (95% CI 0.71–0.88) | ||
| 0.20.5125Ratio (log scale) |
Prevalence of high dTVG · discharge
- dTVG cutoff of 3.5 mm Hg identified patients with high dTVG
- 122 of 474 patients (25.7%)
- Data-driven cutoff
Original publication
Prognostic Impact of Discharge Transprosthetic Tricuspid Gradient After Transcatheter Tricuspid Valve Replacement: The TRIPLACE Registry. JACC Cardiovasc Interv. Published 31 October 2026. doi:10.
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