TR and AFib After M-TEER: A Risk Interaction to Watch | JACC Baran

Hosts Mitsuaki Sawano, MD, Nobu Ikemura, MD, and Satoshi Shoji, MD welcome Dr. Shingo Matsumoto, MD (Toho University) and Dr. Yohei Ohno, MD (Tokai University) to discuss their JACC: Cardiovascular Interventions study, “Atrial Fibrillation and Tricuspid Regurgitation in Patients Undergoing Mitral Valve Transcatheter Edge-to-Edge Repair.” Building on prior evidence that residual tricuspid regurgitation (TR) influences outcomes after M-TEER, this analysis examines how atrial fibrillation (AF) interacts with TR progression and right ventricular remodeling. In a large OCEAN-Mitral cohort, AF was associated with greater TR persistence and progression after M-TEER, distinct patterns of right ventricular dysfunction, and amplified risk of cardiovascular death or heart failure hospitalization when moderate-or-greater TR remained post-procedure. The discussion reframes post–M-TEER management beyond the mitral valve alone, highlighting the importance of right-heart assessment, TR surveillance, and the evolving role of AF in shaping structural heart outcomes.