Mid-term outcomes of transcatheter edge-to-edge repair for severe tricuspid regurgitation in a cohort with intermediate anatomical risk assessed by The GLIDE Score

Introduction and Objectives Transcatheter edge-to-edge repair (T-TEER) of severe tricuspid regurgitation (TR) has demonstrated safety and efficacy; however, procedural success is influenced by the valve’s anatomical features. The recently developed GLIDE score stratifies anatomical risk and correlates with procedural outcomes. This study aimed to evaluate anatomical characteristics based on the GLIDE score, procedural success rates, and mid-term clinical outcomes in a real-world population with severe TR undergoing T-TEER. Methods We conducted a single-center, prospective observational study including all symptomatic patients with severe TR treated with T-TEER from December 2021 to January 2025. Baseline clinical and echocardiographic characteristics, including the GLIDE score (low anatomical risk = 1; high = 4), were collected. Follow-up assessments were performed post-procedure, at hospital discharge, and at 3 months. Mortality and event-free survival were analyzed at median follow-up. Results Forty-four patients (59% female), with a mean age of 73±11 years and prevalent comorbidities, were included. Baseline characteristics are detailed in the Table. Massive or torrential TR was present in 61%, predominantly with functional etiology (73%). The mean GLIDE score was 1.5±0.9, and 52% had a GLIDE score = 2. Procedural success (TR reduction to moderate or less), was achieved in 96%, with significant improvement in TR severity compared to baseline (p<0.005). Median follow-up was 17 months [25th–75th percentile: 11–27]. At 3 months, 91% of patients experienced at least a two-grade reduction in TR severity (p<0.0005), and only 9% remained in NYHA class III–IV (p=0.002). Hospitalizations for heart failure (HF) decreased significantly post-intervention (from 77 to 38 admissions per 100 patient-years; incidence rate ratio 0.50 [95% CI 0.29–0.86], p=0.008). Overall survival and event-free survival at 17 months were 86% and 72%, respectively (Figure). Conclusions In a prospective real-world cohort, T-TEER was safe and effective for the treatment of symptomatic severe TR, yielding significant functional class improvement and reduced HF hospitalizations at mid-term follow-up, despite an intermediate GLIDE anatomical risk profile.