{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T12:45:39Z","timestamp":1770813939480,"version":"3.50.1"},"reference-count":28,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T00:00:00Z","timestamp":1770681600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Mitral regurgitation (MR) and tricuspid regurgitation (TR) commonly coexist in patients with heart failure (HF). Their concomitant occurrence carries a much poorer prognosis than isolated valve disease. Transcatheter edge-to-edge repair (TEER) of MR and TR is safe and effective, but there is limited data on combined MR\/TR TEER.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The study evaluates the safety and efficacy of combined TEER for MR and TR in a real-world cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective safety and efficacy analysis included the first 40 patients treated with combined MR\/TR TEER between 2019 and 2021 at our single tertiary care referral centre.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Combined procedural success (MR reduction \u22652\u00b0 and TR reduction \u22651\u00b0) was achieved in 80% of the cases. Simultaneous TEER was safe, with no intraprocedural death, myocardial infarction (MI), stroke, or major bleeding. At 1-year follow-up, the median New York Heart Association functional (NYHA) class improved by one grade; twelve patients (30%) died, and fourteen patients (35%) were hospitalized for HF. Procedural success and postprocedural residual MR\u2009\u2264\u20091\u00b0 were associated with reduced 1-year mortality rates but not HF hospitalizations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec005\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Combined MR\/TR TEER is safe and reduces MR and TR in most patients, conferring a potential benefit regarding symptoms and prognosis. Randomized controlled trials (RCTs) are needed to rigorously evaluate combination therapy in this setting.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0339837","type":"journal-article","created":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T18:23:54Z","timestamp":1770747834000},"page":"e0339837","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Simultaneous transcatheter edge-to-edge repair (TEER) for severe mitral and tricuspid regurgitation is feasible, safe, and associated with good clinical outcome"],"prefix":"10.1371","volume":"21","author":[{"given":"Johannes","family":"Gollmer","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7479-7767","authenticated-orcid":true,"given":"David","family":"Zweiker","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander","family":"Peikert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8569-3683","authenticated-orcid":true,"given":"Viktoria","family":"Santner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Vosko","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicolas","family":"Verheyen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Klemens","family":"Ablasser","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9349-8068","authenticated-orcid":true,"given":"Ewald","family":"Kolesnik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nora","family":"Schwegel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6062-2210","authenticated-orcid":true,"given":"Birgit","family":"Zirngast","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wolfgang","family":"Marte","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G\u00fcnther","family":"Laufer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Zimpfer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Andreas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva","family":"Buschmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0283-9091","authenticated-orcid":true,"given":"Gabor G.","family":"Toth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heiko","family":"Bugger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6290-3297","authenticated-orcid":true,"given":"Andreas","family":"Zirlik","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albrecht","family":"Schmidt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,2,10]]},"reference":[{"issue":"7","key":"pone.0339837.ref001","doi-asserted-by":"crossref","first-page":"1061","DOI":"10.1002\/ejhf.2929","article-title":"Prevalence, clinical characteristics and outcomes of heart failure patients with or without isolated or combined mitral and tricuspid regurgitation: an analysis from the ESC-HFA heart failure long-term registry","volume":"25","author":"M Adamo","year":"2023","journal-title":"Eur J Heart Fail"},{"issue":"11","key":"pone.0339837.ref002","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1016\/j.jacc.2020.07.035","article-title":"Impact of tricuspid regurgitation on clinical outcomes: the COAPT trial","volume":"76","author":"RT Hahn","year":"2020","journal-title":"J Am Coll Cardiol"},{"issue":"24","key":"pone.0339837.ref003","doi-asserted-by":"crossref","first-page":"2307","DOI":"10.1056\/NEJMoa1806640","article-title":"Transcatheter mitral-valve repair in patients with heart failure","volume":"379","author":"GW Stone","year":"2018","journal-title":"N Engl J Med"},{"issue":"20","key":"pone.0339837.ref004","doi-asserted-by":"crossref","first-page":"1833","DOI":"10.1056\/NEJMoa2300525","article-title":"Transcatheter repair for patients with tricuspid regurgitation","volume":"388","author":"P Sorajja","year":"2023","journal-title":"N Engl J Med"},{"issue":"7","key":"pone.0339837.ref005","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/eurheartj\/ehab395","article-title":"2021 ESC\/EACTS guidelines for the management of valvular heart disease","volume":"43","author":"A Vahanian","year":"2022","journal-title":"Eur Heart J"},{"issue":"11","key":"pone.0339837.ref006","doi-asserted-by":"crossref","first-page":"2175","DOI":"10.1002\/ejhf.2637","article-title":"Evolution of tricuspid regurgitation after transcatheter edge-to-edge mitral valve repair for secondary mitral regurgitation and its impact on mortality","volume":"24","author":"M Adamo","year":"2022","journal-title":"Eur J Heart Fail"},{"issue":"12","key":"pone.0339837.ref007","doi-asserted-by":"crossref","first-page":"1142","DOI":"10.1016\/j.jcin.2018.04.010","article-title":"Combined mitral and tricuspid versus isolated mitral valve transcatheter edge-to-edge repair in patients with symptomatic valve regurgitation at high surgical risk","volume":"11","author":"C Besler","year":"2018","journal-title":"JACC Cardiovasc Interv"},{"issue":"2","key":"pone.0339837.ref008","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.jcin.2018.10.022","article-title":"Outcomes after current transcatheter tricuspid valve intervention: mid-term results from the international TriValve registry","volume":"12","author":"M Taramasso","year":"2019","journal-title":"JACC Cardiovasc Interv"},{"issue":"5","key":"pone.0339837.ref009","doi-asserted-by":"crossref","DOI":"10.1093\/ehjci\/jeab253","article-title":"Multi-modality imaging assessment of native valvular regurgitation: an EACVI and ESC council of valvular heart disease position paper","volume":"23","author":"P Lancellotti","year":"2022","journal-title":"Eur Heart J Cardiovasc Imaging"},{"issue":"12","key":"pone.0339837.ref010","doi-asserted-by":"crossref","first-page":"1342","DOI":"10.1093\/ehjci\/jex139","article-title":"The need for a new tricuspid regurgitation grading scheme","volume":"18","author":"RT Hahn","year":"2017","journal-title":"Eur Heart J Cardiovasc Imaging"},{"issue":"24","key":"pone.0339837.ref011","doi-asserted-by":"crossref","first-page":"2297","DOI":"10.1056\/NEJMoa1805374","article-title":"Percutaneous Repair or Medical Treatment for Secondary Mitral Regurgitation","volume":"379","author":"J-F Obadia","year":"2018","journal-title":"N Engl J Med"},{"issue":"2","key":"pone.0339837.ref012","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.jcmg.2018.11.006","article-title":"Proportionate and disproportionate functional mitral regurgitation: a new conceptual framework that reconciles the results of the MITRA-FR and COAPT Trials","volume":"12","author":"PA Grayburn","year":"2018","journal-title":"JACC Cardiovasc Imaging"},{"issue":"24","key":"pone.0339837.ref013","doi-asserted-by":"crossref","first-page":"2408","DOI":"10.1016\/j.jacc.2021.10.011","article-title":"Outcomes stratified by adapted inclusion criteria after mitral edge-to-edge repair","volume":"78","author":"B Koell","year":"2021","journal-title":"J Am Coll Cardiol"},{"issue":"19","key":"pone.0339837.ref014","doi-asserted-by":"crossref","first-page":"1799","DOI":"10.1056\/NEJMoa2314328","article-title":"Transcatheter valve repair in heart failure with moderate to severe mitral regurgitation","volume":"391","author":"SD Anker","year":"2024","journal-title":"N Engl J Med"},{"issue":"24","key":"pone.0339837.ref015","doi-asserted-by":"crossref","first-page":"2376","DOI":"10.1016\/j.jacc.2024.08.029","article-title":"A volume-based framework reconciling COAPT, MITRA-FR, and RESHAPE-HF2","volume":"84","author":"A Gupta","year":"2024","journal-title":"J Am Coll Cardiol"},{"issue":"23","key":"pone.0339837.ref016","doi-asserted-by":"crossref","first-page":"2803","DOI":"10.1016\/j.jcin.2023.10.002","article-title":"1-year outcomes from the CLASP IID randomized trial for degenerative mitral regurgitation","volume":"16","author":"F Zahr","year":"2023","journal-title":"JACC Cardiovasc Interv"},{"issue":"2","key":"pone.0339837.ref017","doi-asserted-by":"crossref","first-page":"124","DOI":"10.1001\/jama.2024.21189","article-title":"Transcatheter Edge-to-Edge Repair for Severe Isolated Tricuspid Regurgitation: The Tri.Fr Randomized Clinical Trial","volume":"333","author":"E Donal","year":"2025","journal-title":"JAMA"},{"issue":"5","key":"pone.0339837.ref018","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1016\/j.jcin.2019.10.023","article-title":"Combined tricuspid and mitral versus isolated mitral valve repair for severe MR and TR: an analysis from the TriValve and TRAMI registries","volume":"13","author":"M Mehr","year":"2020","journal-title":"JACC Cardiovasc Interv"},{"issue":"7","key":"pone.0339837.ref019","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1007\/s00392-024-02384-8","article-title":"Valve unit instead of intensive or intermediate care unit admission following transcatheter edge-to-edge mitral valve repair is safe and reduces postprocedural complications","volume":"114","author":"M Gr\u00f6ger","year":"2025","journal-title":"Clin Res Cardiol"},{"issue":"11","key":"pone.0339837.ref020","doi-asserted-by":"crossref","DOI":"10.1002\/hsr2.70168","article-title":"The extra length of stay, costs, and mortality associated with healthcare-associated infections: a case-control study","volume":"7","author":"S Moradi","year":"2024","journal-title":"Health Sci Rep"},{"issue":"22","key":"pone.0339837.ref021","doi-asserted-by":"crossref","first-page":"2037","DOI":"10.1056\/NEJMoa2300213","article-title":"Five-year follow-up after transcatheter repair of secondary mitral regurgitation","volume":"388","author":"GW Stone","year":"2023","journal-title":"N Engl J Med"},{"issue":"6","key":"pone.0339837.ref022","doi-asserted-by":"crossref","first-page":"514","DOI":"10.4244\/EIJ-D-21-00846","article-title":"Delayed hospitalisation for heart failure after transcatheter repair or medical treatment for secondary mitral regurgitation: a landmark analysis of the MITRA-FR trial","volume":"18","author":"G Leurent","year":"2022","journal-title":"EuroIntervention"},{"key":"pone.0339837.ref023","article-title":"Tricuspid transcatheter edge-to-edge repair for severe tricuspid regurgitation: 1-year outcomes from the TRILUMINATE randomized cohort","volume":"2024","author":"GHL Tang","year":"2024","journal-title":"J Am Coll Cardiol"},{"issue":"5","key":"pone.0339837.ref024","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/j.jacc.2021.11.031","article-title":"Right ventricular-pulmonary arterial coupling and afterload reserve in patients undergoing transcatheter tricuspid valve repair","volume":"79","author":"MI Brener","year":"2022","journal-title":"J Am Coll Cardiol"},{"issue":"14","key":"pone.0339837.ref025","doi-asserted-by":"crossref","first-page":"1551","DOI":"10.1016\/j.jcin.2021.05.005","article-title":"Right ventricular contraction patterns in patients undergoing transcatheter tricuspid valve repair for severe tricuspid regurgitation","volume":"14","author":"K-P Kresoja","year":"2021","journal-title":"JACC Cardiovasc Interv"},{"issue":"17","key":"pone.0339837.ref026","doi-asserted-by":"crossref","first-page":"1999","DOI":"10.1016\/j.jcin.2020.05.011","article-title":"Impact of massive or torrential tricuspid regurgitation in patients undergoing transcatheter tricuspid valve intervention","volume":"13","author":"M Miura","year":"2020","journal-title":"JACC Cardiovasc Interv"},{"issue":"2","key":"pone.0339837.ref027","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/j.jcin.2022.11.022","article-title":"Concomitant transcatheter edge-to-edge treatment of secondary tricuspid and mitral regurgitation: an expert opinion","volume":"16","author":"A Sisinni","year":"2023","journal-title":"JACC Cardiovasc Interv"},{"issue":"5","key":"pone.0339837.ref028","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1093\/eurheartj\/ehad783","article-title":"Tricuspid valve disease and cardiac implantable electronic devices","volume":"45","author":"M Andreas","year":"2024","journal-title":"Eur Heart J"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0339837","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T18:24:00Z","timestamp":1770747840000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0339837"}},"subtitle":[],"editor":[{"given":"Satoshi","family":"Higuchi","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,2,10]]},"references-count":28,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,2,10]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0339837","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,10]]}}}