Comparative Outcomes of Tricuspid-Dedicated Versus Non-Dedicated Devices in Transcatheter Tricuspid Edge-to-Edge...

BACKGROUND Transcatheter tricuspid edge-to-edge repair (T-TEER) has expanded treatment options for tricuspid regurgitation (TR). The procedure was initially performed using systems designed for mitral valve repair, which were replaced by tricuspid-dedicated devices. This retrospective study compared outcomes of tricuspid-dedicated devices (TriClip or PASCAL) with a non-dedicated device (MitraClip) used for TR treatment. MATERIAL AND METHODS We analyzed data from 44 consecutive patients (mean age 74.7±7.5 years) who underwent T-TEER (2018-2024): 22 with non-dedicated (MitraClip) and 22 with dedicated systems (TriClip or PASCAL). The primary endpoint was technical success. Secondary endpoints included post-procedural TR≤ moderate, ≥2-grade TR reduction, peri-procedural complications, and 6-month mortality. RESULTS Baseline characteristics were largely balanced, although the non-dedicated group showed greater left-ventricular dysfunction. Technical success was significantly higher with dedicated systems (100% vs 77.3%, risk ratio 1.29; 95% CI 1.03-1.63; P=0.048) Post-procedural moderate or less TR and a reduction of ≥2 grades was achieved in 68.2% of patients with dedicated devices vs 31.8% with non-dedicated devices (risk ratio 2.14, 95% CI 1.09-4.21; P=0.02). Mortality during a 6-month follow-up was comparable between both cohorts (0.0% vs 9.1%; risk ratio 1.10; 95% CI 0.96-1.26; P=0.23). CONCLUSIONS Tricuspid-dedicated systems (TriClip or PASCAL) were associated with higher procedural success rates and greater TR reduction. They improved early outcomes and enabled the application of T‑TEER in a broader population of patients with less-advanced heart failure. Given the limited sample size and retrospective design, these findings should be interpreted with caution and regarded as exploratory and hypothesis-generating.