Tricuspid Transcatheter Edge-to-Edge Repair at a Crossroads: Prognosis-Shaping Intervention or High-Tech Palliation?

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Tricuspid regurgitation (TR) is linked to increased morbidity and mortality.
• Isolated TR is often undertreated due to limited survival benefits from surgical correction.
• A need exists for effective, minimally invasive therapies for severe TR.

Purpose of the Study:

• To review the current evidence for transcatheter edge-to-edge repair (T-TEER) in severe TR.
• To discuss patient selection strategies for T-TEER.
• To explore the evolving role of T-TEER in managing TR.

Main Methods:

• Review of recent randomized trials (e.g., TRILUMINATE Pivotal, Tri-FR) and real-world registries.
• Analysis of functional status, quality of life, and TR severity outcomes.
• Evaluation of right ventricular function and anatomical suitability criteria.

Main Results:

• T-TEER consistently improves TR severity, functional status, and quality of life.
• Benefits in hard clinical endpoints like mortality are less conclusive but show potential.
• Patient selection, anatomical suitability, and RV function are key to successful outcomes.

Conclusions:

• T-TEER is a promising option for symptomatic severe TR patients unsuitable for surgery.
• It provides significant symptom relief and potential for broader clinical benefit.
• Ongoing trials will further define the long-term prognostic advantage of T-TEER.