Key result
Commissural K-Clip implantation yields sustained tricuspid regurgitation reduction at 3 months in high-risk severe TR.
Why the study?
The optimal K-Clip deployment geometry for maximal tricuspid annular reduction remains undefined in high-risk patients with functional tricuspid regurgitation.
Does the commissural symmetrical closure strategy using K-Clips improve annular reduction and tricuspid regurgitation in a high-risk patient with refractory functional TR?
Case Report (n=1)
Does the commissural symmetrical closure strategy using K-Clips improve annular reduction and tricuspid regurgitation in a high-risk patient with refractory functional TR?
Answers are grounded in this paper and cite their sources.
The novel commissural symmetrical closure strategy for K-Clip deployment offers a feasible transcatheter annuloplasty approach to maximize annular reduction and relieve severe functional TR in high-risk elderly patients.
BACKGROUND: Refractory functional tricuspid regurgitation (TR) secondary to annular dilatation portends poor prognosis, although conventional open tricuspid surgery carries high-risk in elderly patients. The optimal K-Clip deployment geometry for maximal annular reduction remains undefined. CASE SUMMARY: An 89-year-old pacemaker-dependent man with decompensated right heart failure and refractory functional TR was prohibitively high-risk for open surgery. Preoperative imaging identified anatomy less favorable for transcatheter edge-to-edge tricuspid repair. K-Clips were implanted perpendicularly to tricuspid commissures via the commissural symmetrical closure (CSC) strategy, yielding significant annular reduction. Three-month follow-up showed sustained TR improvement and stable clip positioning. DISCUSSION: Perpendicular orientation geometrically maximizes annular plication, enabling optimal annular contraction and TR relief. Dual fluoroscopic and live 3D transesophageal echocardiographic guidance ensures safe and precise deployment. TAKE-HOME MESSAGE: The commissural symmetrical closure strategy optimizes K-Clip geometric alignment to maximize tricuspid annular reduction and ameliorate severe functional TR, offering a safe and feasible transcatheter annuloplasty approach for high-risk elderly patients.
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Cao et al. (2026) conducted a case report in Refractory functional tricuspid regurgitation and decompensated right heart failure (n=1). K-Clip implantation via commissural symmetrical closure (CSC) strategy was evaluated on Tricuspid regurgitation improvement and clip positioning. K-Clip implantation via the commissural symmetrical closure strategy yielded significant annular reduction and sustained tricuspid regurgitation improvement at 3 months in a high-risk 89-year-old man.
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