Key result
T-TEER linked to ~27-point higher TR ≤2+ success at 1 year vs annuloplasty.
Why the study?
Percutaneous tricuspid edge-to-edge repair is a novel technique to treat tricuspid regurgitation, and the ‘clover’ technique may optimize reduction in tricuspid regurgitant volume in selected patients.
Observational (n=1,122)
Yes
Absolute Event Rate: 89.9% vs 62.9%
p-value: p=<0.001
T-TEER may provide more durable TR reduction than annuloplasty in matched severe cases; leaves open effects on outcomes and optimal device selection.
A 82-year-old male patient with symptoms of left- and right-sided heart failure suffered from severe secondary mitral and secondary moderate-to-severe tricuspid regurgitation with dilatation of the tricuspid annulus. Based on a heart-team decision, a successful percutaneous edge-to-edge repair of both valves was performed (compassionate use approach). The edge-to-edge repair of the tricuspid valve was complicated by the presence of a right-ventricular pacemaker lead. PanelA reveals a transoesophageal echocardiographic (TEE) short axis view at the level of the tricuspid plane. The first clip was placed in the antero-septal commissure followed by a second clip in the antero-posterior commissure of the tricuspid valve creating a ‘clover’-like appearance similar to the surgical ‘clover’ technique by Ottavio Alfieri. The placement of the two clips resulted in a substantial reduction of tricuspid regurgitation from 3+ to 1+. PanelB illustrates the anatomical ‘clover’-like appearance of the tricuspid valve. The Supplementary data online, TEE movie files show the tricuspid valve before and after treatment. Percutaneous tricuspid edge-to-edge repair is a novel technique to treat tricuspid regurgitation; the ‘clover’ technique might be considered in selected patients to achieve an optimal reduction in tricuspid regurgitant volume. Supplementary data are available at European Heart Journal—Cardiovascular Imaging online.
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Hausleiter et al. (2017) conducted an observational in Symptomatic severe secondary tricuspid regurgitation (n=1,122). Tricuspid valve transcatheter edge-to-edge repair (T-TEER) vs. Transcatheter tricuspid valve annuloplasty (TTVA) was evaluated on Proportion of patients achieving residual tricuspid regurgitation ≤2+ at follow-up (propensity score-matched cohort) (p=<0.001). T-TEER achieved higher rates of residual tricuspid regurgitation ≤2+ at 1-year follow-up compared to transcatheter annuloplasty (89.9% vs 62.9%, p<0.001) in matched patients with severe disease.
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