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Multicenter Study
. 2025 Feb;114(2):251-260.
doi: 10.1007/s00392-024-02549-5. Epub 2024 Sep 24.

Robustness of tricuspid regurgitation reduction at 1 year following edge-to-edge repair for primary tricuspid regurgitation

Felix Rudolph  1 , Muhammed Gerçek  2 , Johannes Kirchner  2 , Maria Ivannikova  2 , Kai P Friedrichs  2 , Tanja K Rudolph  2 , Volker Rudolph  2 , Martin Andreas  3 , Anna Bartunek  4 , Philipp E Bartko  5 , Varius Dannenberg  6
Affiliations
Multicenter Study

Robustness of tricuspid regurgitation reduction at 1 year following edge-to-edge repair for primary tricuspid regurgitation

Felix Rudolph et al. Clin Res Cardiol. 2025 Feb.

Erratum in

Abstract

Background and objective: Within recent years, transcatheter tricuspid edge-to-edge repair (T-TEER) has emerged as a safe and effective treatment option in patients with secondary tricuspid regurgitation (TR). However, for primary TR, data on the robustness and durability of TR reduction 1 year following T-TEER is limited.

Methods: All consecutive patients treated with T-TEER for TR at two high-volume centers between September 2018 and December 2022 were enrolled in a registry. Primary TR was defined as tricuspid valve (TV) prolapse or flail TV leaflets as assessed by pre- and peri-interventional transesophageal echocardiography (TEE).

Results: 201 patients were included in this analysis, of whom 27 (13.4%) were classified as primary TR and 174 (86.6%) as TR of secondary origin. All-cause mortality during 1-year follow-up was reached by 50 patients (24.9%) [primary: 7 (25.9%), secondary: 43 (24.7%)], and 151 (75.1%) completed follow-up with transthoracic echocardiography (TTE). Patients' median age was 80 (76-83) years, 112 (55.7%) were female and 181 (90.1%) reported a New-York heart association functional class (NYHA-FC) of III or IV. The remaining baseline clinical and echocardiographic parameters were comparable between the groups, but secondary TR patients had a significantly higher TRI-SCORE (5 (4-8) vs. 7 (5-14), P = 0.010). In both groups, an immediate reduction of TR-Grade post-intervention was observed. This reduction was sustained at follow-up with 80.0% of the primary TR patients classified as moderate or less and 61.8% of the secondary TR patients. This translated to a significant improvement of NHYA-FC in both groups. Kaplan-Meier analysis revealed no differences regarding rates for all-cause mortality between the groups (P < 0.99).

Conclusion: T-TEER achieves a robust TR reduction in primary TR patients 1 year after intervention with noninferior clinical results to treatment for secondary TR with regards to mortality, re-hospitalization, and NYHA-FC.

Keywords: Flail leaflet; Primary tricuspid regurgitation; Prolapse; Right-ventricular remodeling; Transcatheter edge-to-edge repair; Transesophageal echocardiography.

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Conflict of interest statement

Declarations. Conflict of interest: M.G. has received funding from the Ruhr University Bochum (advanced clinician scientist grant) and speaker’s honoraria from Edwards Lifesciences. M.I. has received speaker’s honoraria from Edwards and AstraZeneca. K.P.F. is consultant for and has received speaker’s honoraria from Edwards Lifesciences. T.K.R. received speaker’s honoraria from Boston Scientific, Edwards Lifesciences, JenaValve and Medtronic. V.R. received research grants from Abbott, Boston Scientific and Edwards Lifesciences. A.B. received speaker’s and proctoring honoraria from Abbott. The remaining authors declare to have no conflicts of interest.

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