Real-World Experience in Tricuspid Transcatheter Edge-to-Edge Repair: Transcatheter Tricuspid Valve Repair in Spain Registry

Background: Significant tricuspid regurgitation (TR) is associated with increased morbidity and mortality. The development of transcatheter valve repair therapies has opened a wide range of opportunities for treatment of patients with high surgical risk. Real-world data might improve patient selecti...

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Detalles Bibliográficos
Autores: Sisinni, A, Barreiro-Perez, M, Freixa, X, Arzamendi, D, Moñivas, V, Carrasco-Chinchilla, F, Pan, M, Nombela-Franco, L, Pascual, I, Benito-González, T, Perez, R, Gómez-Blázquez, I, Amat-Santos, IJ, Cruz-González, I, Sánchez-Recalde, A, Alvarez, ABC, Sanchis, L, Caneiro-Queija, B, Li, CH, del Trigo, M, Martínez-Carmona, JD, Mesa, D, Pozo, E, Avanzas, P, Cepas-Guillén, P, Estévez-Loureiro, R
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Institut d’Investigació Biomèdica Sant Pau (IIB Sant Pau)
Repositorio:r-IIB SANT PAU. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica Sant Pau
OAI Identifier:oai:iibsantpau.fundanetsuite.com:p19182
Acceso en línea:https://iibsantpau.fundanetsuite.com/Publicaciones/ProdCientif/PublicacionFrw.aspx?id=19182
Access Level:acceso abierto
Palabra clave:edge-to-edge repair
procedural success
transcatheter treatment
tricuspid regurgitation
TRI-SPA
Descripción
Sumario:Background: Significant tricuspid regurgitation (TR) is associated with increased morbidity and mortality. The development of transcatheter valve repair therapies has opened a wide range of opportunities for treatment of patients with high surgical risk. Real-world data might improve patient selection and outcome. The authors sought to investigate acute and short-term cardiovascular outcomes of tricuspid transcatheter edge-to-edge repair (T-TEER) with dedicated devices in a real-world setting. Methods and Results: This is a retrospective, single-arm, multicenter registry conducted at 15 sites in Spain. The primary end point was a composite of all-cause death, rehospitalization for heart failure, and tricuspid valve re-intervention. Patients included (n=283) were older (76 +/- 9 years, 70% female), and showed significant comorbidities. Massive or torrential TR was present in 55% of subjects, with secondary cause being the main mechanism of regurgitation in approximate to 80% of individuals. Intraprocedural success was achieved in 79% of patients. At 1-year follow-up, significant improvements in TR grade (>= 3+, 100% to 25%, P <0.001) and New York Heart Association functional class (I/II, 33%-86%, P <0.001) were observed. Lead-induced cause and single leaflet device attachment emerged as independent predictors of at least severe predischarge residual TR. In-hospital mortality occurred in 4 (1.4%) patients, whereas the Kaplan-Meier estimated 1-year primary end point occurrence rate was 21%. Intraprocedural success (hazard ratio, 0.353 [95% CI, 0.156-0.798]; P=0.012), was found to be an independent predictor of primary end point. Conclusions: In a real-world contemporary setting, tricuspid transcatheter edge-to-edge repair with dedicated devices emerged as effective therapeutic option for patients with severe TR.