Screening and Qualification for Transcatheter Tricuspid Valve Interventions-Preliminary Findings from the CAPTURE...

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Transcatheter tricuspid edge-to-edge repair (T-TEER) is the primary treatment for severe tricuspid regurgitation (TR).
• A significant number of patients referred for TR treatment are unsuitable for T-TEER or achieve suboptimal results.
• Alternative transcatheter tricuspid valve interventions (TTVI), such as valve implantation, are necessary for these patients.

Purpose of the Study:

• To characterize patients with severe TR referred for transcatheter treatment.
• To identify patients who may require alternative TTVI strategies.
• To analyze factors influencing T-TEER eligibility and outcomes.

Main Methods:

• The CAPTURE Study enrolled consecutive patients referred for TR treatment.
• Patients underwent clinical and echocardiographic assessment for T-TEER eligibility.
• Alternative TTVI candidates were defined by anatomical ineligibility or unsuccessful T-TEER (TR > moderate post-procedure).

Main Results:

• Of 147 enrolled patients, 52.4% were eligible for T-TEER, and 48.3% underwent the procedure with a 77.5% success rate.
• 23.1% of patients were identified as potential candidates for alternative TTVI strategies.
• These patients had more severe TR, right heart failure symptoms, higher bilirubin, lower hemoglobin, and lower platelet counts, indicating increased bleeding risk.

Conclusions:

• Approximately half of severe TR patients are eligible for T-TEER, while over 20% may need alternative TTVI.
• This subgroup exhibits advanced right heart disease and laboratory markers suggesting hepatic dysfunction and elevated bleeding risk.
• These findings are crucial for Heart Team decision-making and procedural planning in complex TR cases.