Valvular & structural heart disease

Tricuspid Regurgitation and 3-Year Mortality After Transseptal Mitral Valve-in-Valve Replacement

JACC Cardiovasc IntervPublished Registry-based cohort study

Authors' conclusion

Preprocedural severe or greater TR, 30-day residual severe or greater TR, and unchanged or worsened TR after transseptal MViV were associated with a significantly increased risk for 3-year all-cause mortality.

Study context

Population
Patients undergoing transseptal mitral valve-in-valve replacement, STS/ACC TVT Registry, 2015–20244,938 met inclusion criteria
Participants
5,971 patients
Exposure
Severe or greater tricuspid regurgitation (TR) vs moderate vs mild or less TR before transseptal mitral valve-in-valve (MViV)
  • Severe or greater TRn = 1,039
Outcome
All-cause mortality
Follow-up
3 years
Methodological detailspropensity-score matched, 513 sites
  • Propensity-score matched
  • 513 sites

Main finding

As reported in the abstract

3-year mortality by baseline TR

P = 0.004

Observational data: associations, not effects.

Further findings

OutcomeModerate TRP value
3-year mortality by residual TR at 30 days · 3 yearsResidual severe or greater TR vs Moderate or less TR30.7%P = 0.04
≥1-grade TR improvement at 30 days (baseline severe or greater TR)
68.1%
  • 3-year mortality by residual TR at 30 days: Residual severe or greater TR 43.2%
  • 3-year mortality by residual TR at 30 days: 30-day landmark analysis

Mortality by change in TR grade, baseline to 30 days

Improvement in TR grade associated with lower mortality vs unchanged or worsened TR

Original publication

Tricuspid Regurgitation and 3-Year Mortality After Transseptal Mitral Valve-in-Valve Replacement. JACC Cardiovasc Interv. Published 9 June 2025. doi:10.1016/j.jcin.2025.04.034

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