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Incidence, Predictors and Outcomes of Bleeding Following Transcatheter Tricuspid Valve Repair: The TriValve Registry

Iryna Dykun1, Giulio Russo2, Amir A Mahabadi3

  • 1Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, Ohio, USA; Department of Cardiology and Vascular Medicine, West German Heart and Vascular Center, University Hospital Essen, Essen, Germany.

JACC. Cardiovascular Interventions
|March 25, 2026
PubMed

Insights

Major bleeding occurs in 11.4% of patients after transcatheter tricuspid valve repair, significantly increasing the risk of death. Optimizing patient selection and procedure duration may reduce bleeding complications.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Structural Heart Disease

Background:

  • Bleeding is a frequent complication of catheter-based structural heart procedures.
  • Clinical implications of bleeding after transcatheter tricuspid valve interventions require systematic evaluation.

Purpose of the Study:

  • To assess the incidence, predictors, and prognostic impact of bleeding following transcatheter tricuspid valve repair.
  • To analyze Bleeding Academic Research Consortium (BARC) bleeding events within one year post-procedure.

Main Methods:

  • Retrospective analysis of 440 patients from the international TriValve registry.
  • Classification of bleeding events using BARC criteria (types 2, 3, and 5).
  • Evaluation of patient factors and procedural characteristics associated with bleeding.

Main Results:

  • The incidence of BARC major bleeding was 11.4%.
  • Predictors included postprocedural tricuspid regurgitation severity, higher pulmonary artery pressures, and longer procedure duration.
  • Major bleeding was linked to increased in-hospital death and a higher risk of 1-year composite outcomes (death or readmission).

Conclusions:

  • Major bleeding following transcatheter tricuspid valve repair affects approximately 11% of patients.
  • Bleeding is a significant determinant of both in-hospital and 1-year mortality.
  • Improved patient selection and procedural optimization, including shorter procedure times, may mitigate bleeding risk.
Abstract

Keywords:
BARCTriValve registrybleedingtranscatheter tricuspid valve repair

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