T-TEER showed fewer procedural complications than TTVA (4.5% vs 27.0%, P<0.001) but similar 1-year freedom from mortality or heart failure hospitalization (75.0% vs 79.8%, P=0.408).
Cohort (n=1,122)
Does transcatheter tricuspid valve edge-to-edge repair (T-TEER) improve procedural and clinical outcomes compared to transcatheter tricuspid valve annuloplasty (TTVA) in patients with severe secondary tricuspid regurgitation?
In patients with severe secondary tricuspid regurgitation, T-TEER offers a better safety profile and more effective TR reduction at discharge compared to TTVA, though 1-year clinical outcomes are similar.
Absolute Event Rate: 75% vs 79.8%
p-value: p=0.408
BACKGROUND: Transcatheter tricuspid valve (TV) interventions are an effective treatment option for patients with severe symptomatic tricuspid regurgitation (TR). TV transcatheter edge-to-edge repair (T-TEER) and transcatheter TV annuloplasty (TTVA) represent distinct repair strategies; however, comparative data remain limited. OBJECTIVES: The objective of the study was to compare procedural and clinical outcomes after T-TEER and TTVA in patients with severe secondary TR. METHODS: Consecutive T-TEER or TTVA-treated patients (2017-2024) were included. A 1:1 propensity-score matching was performed. Endpoints included residual TR ≤ 1+/≤2+, a ≥2-grade reduction, procedural complications, symptomatic improvement, reinterventions, and the composite of all-cause mortality or first heart failure hospitalization within 1 year. RESULTS: Among 1,122 patients (882 T-TEER; 240 TTVA), 111 well-balanced matched pairs were identified. At discharge, T-TEER achieved higher rates of residual TR ≤ 1+ (50.0% vs 34.2%) and ≤2+ (87.7% vs 67.6%; all P < 0.05) compared with TTVA, whereas a ≥2-grade reduction was comparable. Procedural complications were less frequent with T-TEER (any complication: 4.5% vs 27.0% for T-TEER vs TTVA; P < 0.001). Symptomatic improvement and reintervention rates within 1 year were similar between groups. Freedom from the composite endpoint of all-cause mortality or first heart failure hospitalization at 1-year was 75.0% (95% CI: 66.8-84.1) after T-TEER and 79.8% (95% CI: 72.4-87.9) after TTVA (P = 0.408). CONCLUSIONS: In patients with severe secondary TR and sufficient clinical and anatomical overlap for matched comparison, T-TEER showed a more favorable safety profile and more effective, durable TR reduction, whereas early clinical outcomes at 1 year were comparable after adjustment for baseline differences, highlighting the need for longer-term evaluation.
“These findings highlight the importance of procedural safety and durable TR reduction, while underscoring the complexity of translating procedural success into early clinical benefit and the need for longer-term evaluation.”
This is the largest comparison of T-TEER and TTVA for severe secondary tricuspid regurgitation, providing important insights into the safety and efficacy of these two interventions.
Stein et al. (Wed,) conducted a cohort in Severe secondary tricuspid regurgitation (n=1,122). Transcatheter tricuspid valve edge-to-edge repair (T-TEER) vs. Transcatheter tricuspid valve annuloplasty (TTVA) was evaluated on Freedom from the composite of all-cause mortality or first heart failure hospitalization at 1-year (p=0.408). T-TEER showed fewer procedural complications than TTVA (4.5% vs 27.0%, P<0.001) but similar 1-year freedom from mortality or heart failure hospitalization (75.0% vs 79.8%, P=0.408).