Real‐World Experience in Tricuspid Transcatheter Edge‐to‐Edge Repair: Transcatheter Tricuspid Valve Repair in Spain Registry

• Published in: Journal of the American Heart Association Vol. 14; no. 2; p. e037070
• Main Authors: Sisinni, Antonio, Barreiro‐Perez, Manuel, Freixa, Xavier, Arzamendi, Dabit, Moñivas, Vanessa, Carrasco‐Chinchilla, Fernando, Pan, Manuel, Nombela‐Franco, Luis, Pascual, Isaac, Benito‐González, Tomás, Perez, Ruth, Gómez‐Blázquez, Iván, Amat‐Santos, Ignacio J., Cruz‐González, Ignacio, Sánchez‐Recalde, Ángel, Alvarez, Ana Belén Cid, Sanchis, Laura, Caneiro‐Queija, Berenice, Li, Chi Hion, del Trigo, Maria, Martínez‐Carmona, Jose David, Mesa, Dolores, Pozo, Eduardo, Avanzas, Pablo, Cepas‐Guillén, Pedro, Estévez‐Loureiro, Rodrigo
• Format: Journal Article
• Language: English
• Published: England John Wiley and Sons Inc 21.01.2025; Wiley
• Subjects: Aged; Aged, 80 and over; Cardiac Catheterization - adverse effects; Cardiac Catheterization - instrumentation; Cardiac Catheterization - methods; Cardiac Catheterization - mortality; edge‐to‐edge repair; Female; Heart Valve Prosthesis Implantation - adverse effects; Heart Valve Prosthesis Implantation - instrumentation; Heart Valve Prosthesis Implantation - methods; Heart Valve Prosthesis Implantation - mortality; Humans; Male; Original Research; procedural success; Registries; Retrospective Studies; Risk Factors; Spain - epidemiology; Time Factors; transcatheter treatment; Treatment Outcome; tricuspid regurgitation; Tricuspid Valve - diagnostic imaging; Tricuspid Valve - physiopathology; Tricuspid Valve - surgery; Tricuspid Valve Insufficiency - diagnostic imaging; Tricuspid Valve Insufficiency - mortality; Tricuspid Valve Insufficiency - physiopathology; Tricuspid Valve Insufficiency - surgery; TRI‐SPA; Spain; tricuspid regurgitation; transcatheter treatment; edge‐to‐edge repair; procedural success; TRI‐SPA
• ISSN: 2047-9980; 2047-9980
• DOI: 10.1161/JAHA.124.037070

Significant tricuspid regurgitation (TR) is associated with increased morbidity and mortality. The development of transcatheter valve repair therapies has opened a wide range of opportunities for treatment of patients with high surgical risk. Real-world data might improve patient selection and outcome. The authors sought to investigate acute and short-term cardiovascular outcomes of tricuspid transcatheter edge-to-edge repair (T-TEER) with dedicated devices in a real-world setting. This is a retrospective, single-arm, multicenter registry conducted at 15 sites in Spain. The primary end point was a composite of all-cause death, rehospitalization for heart failure, and tricuspid valve re-intervention. Patients included (n=283) were older (76±9 years, 70% female), and showed significant comorbidities. Massive or torrential TR was present in 55% of subjects, with secondary cause being the main mechanism of regurgitation in ≈80% of individuals. Intraprocedural success was achieved in 79% of patients. At 1-year follow-up, significant improvements in TR grade (≥3+, 100% to 25%, <0.001) and New York Heart Association functional class (I/II, 33%-86%, <0.001) were observed. Lead-induced cause and single leaflet device attachment emerged as independent predictors of at least severe predischarge residual TR. In-hospital mortality occurred in 4 (1.4%) patients, whereas the Kaplan-Meier estimated 1-year primary end point occurrence rate was 21%. Intraprocedural success (hazard ratio, 0.353 [95% CI, 0.156-0.798]; =0.012), was found to be an independent predictor of primary end point. In a real-world contemporary setting, tricuspid transcatheter edge-to-edge repair with dedicated devices emerged as effective therapeutic option for patients with severe TR.