Stephanie Brunner

Background: Transcatheter tricuspid edge‐to‐edge repair (T‐TEER) has developed as a treatment option for patients experiencing severe tricuspid regurgitation. T‐TEER consistently reduces tricuspid regurgitation, but data on subsequent right heart remodeling remain limited. The aim of this study was to evaluate changes in right heart dimension and function after T‐TEER using extended echocardiographic follow‐up. Methods: The study was based on the international EuroTR (European Registry of Transcatheter Repair for Tricuspid Regurgitation), including patients undergoing T‐TEER between 2016 and 2024 at 18 European centers. Eligible were patients with available baseline and follow‐up (≥90 days postprocedure) echocardiographic assessment. Results: A total of 699 patients (mean age, 78±8 years; 56% women) were included in the analysis. Echocardiographic follow‐up was performed at a median of 407 days (interquartile range, 205–801 days). Right heart dimensions significantly decreased: right ventricular (RV) midventricular diameter from 40.2±8.9 to 37.1±8.4 mm ( P 2 ( P P P <0.001) was observed. Conclusions: In the subset of surviving patients with available echocardiographic follow‐up, treatment with T‐TEER led to favorable long‐term changes with reduced RV dimension, associated with procedural success. RV function modestly decreased, likely reflecting normalization after volume unloading.

Background: Patients with large aortic annuli are a more challenging subgroup for transcatheter aortic valve implantation (TAVI), and data on long‐term outcomes are sparse. Aims: Compare outcomes of patients with large annular anatomies to outcomes of patients with regular anatomies. Methods: Between January 2015 and November 2025, 488 patients underwent TAVI with different generations of Evolut valves for the treatment of native aortic stenosis. Outcomes of large 34 mm valves were compared to regular size 23−29 mm valves. To account for the nonrandomized design, the primary comparison was performed in a 1:1 propensity score matching cohort. Results: A total of 186 (38%) patients received large and 302 (62%) received regular size valves. Propensity score matching yielded 141 well‐balanced pairs, in whom age (80 ± 6 vs. 81 ± 6 years), STS‐PROM score (3.2 [2.0−4.9] vs. 3.6 [2.1−5.8]), and male sex (96% vs. 97%), were comparable. Procedural technical success (95% vs. 94%), device success (90% vs. 92%), and early safety (79% vs. 79%) were comparable. At 30 days, mortality (2.1% vs. 1.4%), stroke (2.1% vs. 3.5%), and new pacemaker implantation (12% vs. 11%) did not differ significantly. At 5 years, there were no significant differences between the groups in all‐cause mortality (HR 1.06, 95% CI 0.64–1.76, p = 0.8), stroke (sHR 0.74, 95% CI 0.26−2.11, p = 0.6), heart failure rehospitalization (sHR 0.96, 95% CI 0.46−2.01, p =0.9), or new pacemaker implantation (sHR 1.02, 95% CI 0.57−1.82, p = 0.9). Structural valve deterioration stage 3 (0% vs. 1.6%), infective endocarditis (1.7% vs. 2.8%), and valve reintervention (0% vs. 0.9%) were infrequent in both groups. The findings were consistent in the whole‐cohort analysis. Conclusion: Outcomes after TAVI with large self‐expanding valves were comparable to regular size valves, demonstrating favorable results up to 5 years of follow‐up.

Background: Early rehospitalisation after transcatheter aortic valve implantation (TAVI) is frequently required but data regarding its prevalence, aetiology, predictors and prognostic relevance are limited. Methods: We retrospectively analysed consecutive patients undergoing TAVI between August 2012 and October 2025. Early rehospitalisation was defined as any admission within 30 days from the index hospitalisation. Data regarding rehospitalisation causes, predictors, outcomes and impact on mortality were collected. Associations were evaluated using univariable and multivariable logistic and Cox regression models and Kaplan-Meier curve analyses. Results: A total of 1347 patients (43.8% women, mean age 81±6 years) were included. Early rehospitalisation was required in 131 (9.7%), most frequently due to infection (22.9%), heart failure (HF 19.8%) and bradycardia (9.9%). Independent predictors of rehospitalisation for infection were chronic HF (OR 2.60, 95% CI 1.02 to 6.59; p=0.045), chronic obstructive pulmonary disease (OR 3.18, 95% CI 1.27 to 7.96; p=0.013) and contrast dye volume (OR 1.25 per 25 mL increase, 95% CI 1.09 to 1.44; p=0.002). Rehospitalisation for decompensated HF was significantly associated with chronic HF (OR 3.82, 95% CI 1.24 to 11.81; p=0.020), paravalvular leak ≥mild (OR 5.05, 95% CI 1.50 to 16.98; p=0.009) and reduced postprocedural ejection fraction (OR 3.85, 95% CI 1.20 to 12.50; p=0.022). Conduction abnormalities at discharge predicted rehospitalisation for bradycardia requiring pacemaker implantation (OR 4.65, 95% CI 1.39 to 15.57; p=0.013). Early (≤2 days) discharge was not associated with an increased risk of rehospitalisation (27.7% vs 20.3%, p=0.073). 1-year all-cause mortality was higher for the early rehospitalisation group after multivariable adjustment (HR 3.03, 95% CI 1.90 to 4.86; p<0.001). Conclusions: Nearly one-tenth of patients were readmitted after index hospitalisation. The most prevalent causes were infection, HF and bradycardia. Modifiable risk factors were contrast dye volume, ≥mild paravalvular leaks and discharge conduction abnormalities. Early discharge did not predict rehospitalisation. Mortality risk at 1 year was three times higher in patients requiring early rehospitalisation.