Postprocedural Changes of Tricuspid Regurgitation After MitraClip Therapy for Mitral Regurgitation

The effect of percutaneous mitral valve repair using the MitraClip system on tricuspid regurgitation (TR) has not been well investigated. We retrospectively analyzed 102 consecutive patients who underwent the successful MitraClip procedure, and who also had a preprocedural and 1-year follow-up transthoracic echocardiography. TR severity was graded by standard guideline-recommended criteria. At 1 year after the MitraClip procedure, the degree of TR regressed (at least 1 grade) in 23% of the patients, was unchanged in 62% of the patients, and progressed in 16% of the patients. Compared with patients in the other groups, the patients with TR regression had a greater severity of TR at baseline. The TR regression group showed a significant reduction in the systolic pulmonary artery pressure (sPAP) (49 ± 13 to 37 ± 11 mm Hg, p <0.05), a right-sided cardiac reverse remodeling (right ventricular diameter: 41 ± 7 to 39 ± 7 mm, tricuspid annular diameter: 48 ± 8 to 46 ± 9 mm, both p <0.05), and an increase in the right ventricular fractional area change (38 ± 7 to 40 ± 7%, p <0.05). In the multivariate analysis, the decrease in sPAP was the only independent parameter change associated with TR regression. In conclusion, TR regression was observed in 23% of the patients after the successful MitraClip procedures, and favorable echocardiographic parameter changes were detected in this group. Only a reduction in sPAP was independently associated with TR regression.