Transcatheter Edge-to-Edge Repair in Patients With Primary Tricuspid Regurgitation

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Primary tricuspid regurgitation (TR) stems from leaflet degeneration, unlike secondary TR.
• TR increases mortality risk and causes right heart congestion.
• Transcatheter edge-to-edge repair (TEER) is established for TR, but its use in primary TR is under investigation.

Purpose of the Study:

• To evaluate the safety and feasibility of TEER in patients with primary TR.
• To assess the efficacy of TEER in reducing tricuspid regurgitation severity.

Main Methods:

• A multicenter cohort study (primary TR registry) included patients undergoing TEER.
• Echocardiography classified leaflet pathology (types 1, 2, 3, 4).
• The primary endpoint was TR reduction to moderate or less at discharge.

Main Results:

• 114 patients (mean age 79.9 years) with primary TR underwent TEER.
• Successful device deployment occurred in 95.6%, with 83.3% achieving TR reduction to moderate or less at discharge.
• At 1 year, 79.7% had TR moderate or less, with significant reverse remodeling and improved NYHA functional class.

Conclusions:

• TEER is a safe and effective treatment for primary TR.
• The procedure promotes right heart reverse remodeling and symptomatic improvement.
• TEER offers a crucial alternative to surgery for carefully selected primary TR patients.