Abstract
Transcatheter tricuspid valve repair (TTVr) has emerged as an alternative for the treatment of severe tricuspid regurgitation (TR). We report our initial experience with an edge-to-edge TTVr system in a high-volume institution. Methods: We included consecutive patients who underwent edge-to-edge TTVr systems. The primary efficacy endpoint was a reduction in the TR of at least one grade. The primary safety endpoint was procedure-related clinical serious adverse events. Results: A total of 28 patients underwent TTVr with edge-to-edge systems. All patients presented with at least severe TR with a high impact on quality of life (82% of patients in NYHA class ≥ III). The Triclip system was the most used device (89%). The primary efficacy endpoint was met in all patients. Only one patient experienced a procedural complication (femoral pseudoaneurysm). At three-month follow-up, 83% of patients were in NYHA I or II (18% baseline vs. 83% 3 months follow-up; p < 0.001). Echocardiography follow-up showed residual TR ≤ 2 in 79% of patients (paired p < 0.001). At the maximum follow-up (median follow up = 372 days), no patients had died. Conclusions: Edge-to-edge TTVr systems seem to represent a very valid alternative to prevent morbidity and mortality associated with TR as depicted by the favorable efficacy and safety.
Highlights
Up to 86% of tricuspid valve surgeries are performed during left-sided heart disease interventions [1] with isolated tricuspid valve (TV) surgery being a rare procedure with an in-hospital mortality of nearly 10% [4]
Transcatheter tricuspid valve repair (TTVr) techniques have emerged as an alternative for the treatment of severe tricuspid regurgitation (TR) in patients ineligible for surgery
Baseline clinical characteristics are summarized in TR ≥ 3 with a high impact on quality of life according to the baseline New York Heart Association (NYHA) class (82% of patients in NYHA class ≥ III) and hospitalizations for heart failure within the previous year (40% of patients)
Summary
Tricuspid regurgitation (TR) has been the subject of increasing interest in recent years, mainly because of its association with an increased risk of mortality and morbidity [1,2,3]. Operative mortality risk related to right ventricular dysfunction and a high comorbidity burden are usually the main reasons why patients are turned down for surgery. Transcatheter tricuspid valve repair (TTVr) techniques have emerged as an alternative for the treatment of severe TR in patients ineligible for surgery. These techniques seem to offer symptomatic improvement and a reduction in heart failure related hospitalizations with a low rate of complications [2,5,6]
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