System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

Journal Article Multicenter Study Observational Study Ppublish

PubMed: 41881647 DOI: 10.1016/j.jcin.2026.01.288

Incidence, Predictors and Outcomes of Bleeding Following Transcatheter Tricuspid Valve Repair: The TriValve Registry.

JACC Cardiovasc Interv 19(6):711-722

Authors: Iryna Dykun, Giulio Russo, Amir A Mahabadi, Holger Thiele, Hannes Alessandrini, Martin Andreas, Kim A Connelly, Rodrigo Estevez-Loureiro, Rebecca T Hahn, Francesco Maisano, Jörg Hausleiter, Tienush Rassaf, Dominique Himbert, Azeem Latib, Vanessa Monivas, Neil Fam, Giovanni Pedrazzini, Marianna Adamo, Horst Sievert, John G Webb, Gilbert H L Tang, Lukas Stolz, Philipp Lurz, Tomas Benito-Gonzalez, Maurizio Taramasso, Rishi Puri

Affiliations

  • Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA; Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany.
  • Department of Biomedicine and Prevention, Cardiology Unit, Policlinico Tor Vergata, University of Rome, Rome, Italy.
  • Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany.
  • Heart Center Leipzig at Leipzig University, Leipzig, Germany.
  • Department of Cardiology, Asklepios Clinic Sankt Georg, Hamburg, Germany.
  • Department of Cardiac Surgery, Medical University of Vienna, Vienna, Austria.
  • Division of Cardiology, Toronto Heart Center, St. Michael's Hospital, Toronto, Ontario, Canada.
  • Interventional Cardiology Clinic, University Hospital Alvaro Cunqueiro, Vigo, Spain.
  • Division of Cardiology, Columbia University Medical Center, NewYork-Presbyterian Hospital, New York, New York, USA.
  • Division of Cardiology and Department of Cardiac Surgery, San Raffaele University Hospital, Milan, Italy.
  • Medical Clinic and Polyclinic I, University Hospital of Munich, Munich, Germany; German Center for Cardiovascular Research, Partner Site Munich Heart Alliance, Munich, Germany.
  • Division of Cardiology, Bichat Hospital, Paris, France.
  • Division of Cardiology, Montefiore Medical Center, New York, New York, USA.
  • Division of Cardiology, Puerta de Hierro University Hospital, Madrid, Spain.
  • Division of Cardiology, Cardiocentro Ticino Institute, EOC, Lugano, Switzerland; Biomedical Faculty, Università della Svizzera Italiana, Lugano, Switzerland.
  • Institute of Cardiology, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy.
  • CardioVascular Center Frankfurt CVC, Frankfurt, Germany.
  • St. Paul Hospital, Vancouver, British Columbia, Canada.
  • Department of Cardiovascular Surgery, Mount Sinai Health System, New York, New York, USA.
  • Division of Cardiology, University Medical Center, Mainz, Germany.
  • Department of Cardiology, University Hospital of León, León, Spain.
  • HerzZentrum Hirslanden, Zurich, Switzerland.
  • Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA.

Abstract

BACKGROUND

Bleeding remains among the most common complications following catheter-based structural heart procedures. Its clinical implications following transcatheter tricuspid valve interventions have yet to be systematically evaluated.

OBJECTIVES

The aim of this study was to evaluate the incidence of bleeding and its predictors and prognostic implications following transcatheter tricuspid valve repair.

METHODS

TriValve (International Multisite Transcatheter Tricuspid Valve Therapies Registry; NCT03416166) is an international multicenter registry capturing a range of transcatheter tricuspid valve interventions. Bleeding events were classified according to the Bleeding Academic Research Consortium (BARC). For this analysis, BARC bleeding events type 2, 3, and 5 occurring within 1 year of transcatheter tricuspid valve repair were retrospectively evaluated.

RESULTS

A total of 440 patients (mean age 76.6 ± 8.9 years, 57.7% women) were included. The BARC major bleeding incidence was 11.4% (50 patients). Postprocedural tricuspid regurgitation severity (adjusted ORl]: 1.83; 95% CI: 1.12-3.01; P = 0.02), higher systolic pulmonary artery pressures (adjusted OR: 1.61; 95% CI: 1.16-2.24; P = 0.0048), and increasing procedure duration (adjusted OR: 1.49; 95% CI: 1.00-2.22; P = 0.049) were associated with bleeding, whereas concomitant oral anticoagulation was not (adjusted OR: 1.51; 95% CI: 0.74-3.10; P = 0.30). Major bleeding was associated with a markedly increased risk for in-hospital death (adjusted OR: 106; 95% CI: 1.31-8,553; P = 0.04). Likewise, bleeding was significantly associated with a 1-year composite of death or all-cause hospital readmission (adjusted HR: 2.41; 95% CI: 1.39-4.19; P = 0.002), all-cause death (adjusted HR: 3.55; 95% CI: 1.75-7.21; P = 0.0004), and cardiovascular death (adjusted HR: 3.72; 95% CI: 1.62-8.52; P = 0.002).

CONCLUSIONS

BARC major bleeding occurs in about 11% of patients following transcatheter tricuspid valve repair and is a major determinant of in-hospital and 1-year death. Enhanced patient selection and procedural optimization (with shorter procedural times) may help curb bleeding risk.

MeSH

Registries, Hemorrhage, Incidence, Tricuspid Valve, Catheters