{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T10:57:07Z","timestamp":1784372227258,"version":"3.55.0"},"reference-count":15,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T00:00:00Z","timestamp":1709510400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background. The significance of concomitant tricuspid regurgitation (TR) in the context of transcatheter aortic valve replacement (TAVR) remains unclear. This study aimed to analyze the severity of TR before and after TAVR with regard to short- and long-term survival and to analyze the influencing factors. Methods. In our retrospective analysis, TR before and after TAVR was examined and patients were classified into groups accordingly. Special attention was paid to patients with post-interventional changes in TR. Mortality after TAVR was considered the primary endpoint of the analysis and major complications according to the Valve Academic Research Consortium 3 (VARC3) were compared. Moreover, biomarkers and risk factors for worsening or improvement of TR through TAVR were analyzed. Results. Among 775 patients who underwent TAVR in our center between January 2009 and December 2019, 686 patients (89%) featured low- and 89 patients (11%) high-grade TR. High-grade pre-TAVR TR was associated with worse short- (30-day), mid- (2-year) and long-term survival up to 8 years. Even though in nearly half of the patients with high-grade TR the regurgitation improved within seven days after TAVR (n = 42\/89), this did not result in a survival benefit for this subgroup. On the other hand, a worsening of low-grade TR was seen in more than 10% of the patients (n = 73\/686), which was also associated with a worse prognosis. Predictors of worsening of TR after TAVR were adipositas, impaired right ventricular function and the presence of mild TR. Age, atrial fibrillation, COPD, impaired renal function and elevated cardiac biomarkers were risk factors for mortality after TAVR independent from the grade of TR. Conclusions. Not only pre-interventional, but also post-TAVR high-grade TR is associated with a worse prognosis after TAVR. TAVR can change concomitant tricuspid regurgitation, but improvement does not have any impact on short- and long-term survival. Worsening of TR after TAVR is possible and impairs the prognosis.<\/jats:p>","DOI":"10.3390\/jcm13051474","type":"journal-article","created":{"date-parts":[[2024,3,4]],"date-time":"2024-03-04T04:36:21Z","timestamp":1709526981000},"page":"1474","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Tricuspid Regurgitation and TAVR: Outcomes, Risk Factors and Biomarkers"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4990-1892","authenticated-orcid":false,"given":"Thomas","family":"Puehler","sequence":"first","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller Strasse 3, D-24105 Kiel, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg\/Kiel\/L\u00fcbeck, 23562 L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nina Sophie","family":"Pommert","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller Strasse 3, D-24105 Kiel, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg\/Kiel\/L\u00fcbeck, 23562 L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Freitag-Wolf","sequence":"additional","affiliation":[{"name":"Institute of Medical Informatics and Statistics, University Medical Center Schleswig-Holstein, Campus Kiel, D-24105 Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hatim","family":"Seoudy","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III (Cardiology, Angiology, and Critical Care), University Medical Center Schleswig-Holstein, Campus Kiel, D-24105 Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6446-0865","authenticated-orcid":false,"given":"Markus","family":"Ernst","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller Strasse 3, D-24105 Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Assad","family":"Haneya","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller Strasse 3, D-24105 Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janarthanan","family":"Sathananthan","sequence":"additional","affiliation":[{"name":"Center for Heart Valve Innovation & Cardiovascular Translational Laboratory, St Paul\u2019s Hospital, University of British Columbia, Vancouver, BC V5Z 1M9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie L.","family":"Sellers","sequence":"additional","affiliation":[{"name":"Center for Heart Valve Innovation & Cardiovascular Translational Laboratory, St Paul\u2019s Hospital, University of British Columbia, Vancouver, BC V5Z 1M9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5524-5844","authenticated-orcid":false,"given":"David","family":"Meier","sequence":"additional","affiliation":[{"name":"Center for Heart Valve Innovation & Cardiovascular Translational Laboratory, St Paul\u2019s Hospital, University of British Columbia, Vancouver, BC V5Z 1M9, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Sch\u00f6ttler","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller Strasse 3, D-24105 Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8223-2638","authenticated-orcid":false,"given":"Oliver J.","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg\/Kiel\/L\u00fcbeck, 23562 L\u00fcbeck, Germany"},{"name":"Department of Internal Medicine III (Cardiology, Angiology, and Critical Care), University Medical Center Schleswig-Holstein, Campus Kiel, D-24105 Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2636-7508","authenticated-orcid":false,"given":"Mona","family":"Salehi Ravesh","sequence":"additional","affiliation":[{"name":"Department of Radiology and Neuroradiology, University Medical Center Schleswig-Holstein, Campus Kiel, D-24105 Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8680-3706","authenticated-orcid":false,"given":"Mohammed","family":"Saad","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III (Cardiology, Angiology, and Critical Care), University Medical Center Schleswig-Holstein, Campus Kiel, D-24105 Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7561-075X","authenticated-orcid":false,"given":"Derk","family":"Frank","sequence":"additional","affiliation":[{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg\/Kiel\/L\u00fcbeck, 23562 L\u00fcbeck, Germany"},{"name":"Department of Internal Medicine III (Cardiology, Angiology, and Critical Care), University Medical Center Schleswig-Holstein, Campus Kiel, D-24105 Kiel, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9145-3210","authenticated-orcid":false,"given":"Georg","family":"Lutter","sequence":"additional","affiliation":[{"name":"Department of Cardiac and Vascular Surgery, University Medical Center Schleswig-Holstein, Campus Kiel, Arnold-Heller Strasse 3, D-24105 Kiel, Germany"},{"name":"DZHK (German Centre for Cardiovascular Research), Partner Site Hamburg\/Kiel\/L\u00fcbeck, 23562 L\u00fcbeck, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,3,4]]},"reference":[{"key":"ref_1","first-page":"ehab395","article-title":"2021 ESC\/EACTS Guidelines for the management of valvular heart disease: Developed by the Task Force for the management of valvular heart disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery 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Imaging"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/5\/1474\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:08:48Z","timestamp":1760105328000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/5\/1474"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,4]]},"references-count":15,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,3]]}},"alternative-id":["jcm13051474"],"URL":"https:\/\/doi.org\/10.3390\/jcm13051474","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,4]]}}}