Impact of age on outcomes after transcatheter tricuspid valve edge-to-edge repair: insights from EuroTR

Objective: Age stratified data regarding symptomatic and survival outcome of patients undergoing transcatheter tricuspid valve edge-to-edge repair (T-TEER) for severe tricuspid regurgitation (TR) are scarce. Aim of this study was to evaluate TR reduction, symptomatic outcomes, and survival following T-TEER stratified by patient age at intervention. Methods: Using data from the large European Registry of Transcatheter Repair for Tricuspid Regurgitation (EuroTR registry, NCT06307262) we investigated the impact of patient age at intervention on procedural TR reduction, clinical outcome according to New York Heart Association (NYHA) class at latest available follow-up and two-year survival as well as two-year survival free from hospitalization for heart failure (HHF). Results: The study included 2340 patients divided into four groups according to quartiles of age at intervention (1st quartile: 668 patients [69.9 ± 7.2 years] up to 4th quartile: 561 patients [86.2 ± 2.2 years]). Most common TR etiology in all groups was secondary TR with 83.6%-90.1%. TR reduction from baseline to discharge was similar in all groups (TR ≤2+ 77.3% 1st quartile, 82% 2nd quartile, 79.5% 3rd quartile and 82.8% 4th quartile, p = 0.085). TR severity at follow-up was also comparable (TR ≤2+ 68.1% 1st quartile, 72.1% 2nd quartile, 76.7% 3rd quartile and 73.7% 4th quartile, p = 0.135). Regarding NYHA class patients in all groups benefited equally. Overall two-year survival and two-year survival free from HHF after intervention did not differ between age groups. Conclusions: T-TEER effectively reduces TR in elderly patients. Irrespective of age, patients showed symptomatic benefit and comparable two-year survival free from HHF.