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

Abstract

Background 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. Methods and Results 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%, P <0.001) and New York Heart Association functional class (I/II, 33%–86%, P <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]; P=0.012), was found to be an independent predictor of primary end point. Conclusions 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.

Keywords

• edge‐to‐edge repair
• procedural success
• transcatheter treatment
• tricuspid regurgitation
• TRI‐SPA