Short-Term Outcomes of Tricuspid Edge-to-Edge Repair in Clinical Practice.

Lurz, Philipp; Besler, Christian; Schmitz, Thomas; Bekeredjian, Raffi; Nickenig, Georg; Möllmann, Helge; von Bardeleben, Ralph Stephan; Schmeisser, Alexander; Atmowihardjo, Iskandar; Estevez-Loureiro, Rodrigo; Lubos, Edith; Heitkemper, Megan; Huang, Dina; Lapp, Harald; Donal, Erwan (2023). Short-Term Outcomes of Tricuspid Edge-to-Edge Repair in Clinical Practice. Journal of the American College of Cardiology, 82(4), pp. 281-291. Elsevier 10.1016/j.jacc.2023.05.008

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BACKGROUND

Severe tricuspid regurgitation (TR) is known to be associated with substantial morbidity and mortality.

OBJECTIVES

The authors sought to study the acute outcomes of subjects treated by tricuspid transcatheter edge-to-edge repair with the TriClip system (Abbott) in a contemporary, real-world setting.

METHODS

The bRIGHT (An Observational Real-World Study Evaluating Severe Tricuspid Regurgitation Patients Treated With the Abbott TriClip™ Device) postapproval study is a prospective, single-arm, open-label, multicenter, postmarket registry conducted at 26 sites in Europe. Echocardiographic assessment was performed at a core laboratory.

RESULTS

Enrolled subjects were elderly (79 ± 7 years of age) with significant comorbidities. Eighty-eight percent had baseline massive or torrential TR, and 80% of subjects were in NYHA functional class III or IV. Successful device implantation occurred in 99% of subjects, and TR was reduced to ≤moderate at 30 days in 77%. Associated significant improvements in NYHA functional class (I/II, 20% to 79%; P < 0.0001) and Kansas City Cardiomyopathy Questionnaire score (19 ± 23 points improvement; P < 0.0001) were observed at 30 days. With baseline TR grade removed as a variable, smaller right atrial volume and smaller tethering distance at baseline were independent predictors of TR reduction to ≤moderate at discharge (OR: 0.679; 95% CI: 0.537-0.858; P = 0.0012; OR: 0.722; 95% CI: 0.564-0.924; P = 0.0097). Fourteen subjects (2.5%) experienced a major adverse event at 30 days.

CONCLUSIONS

Transcatheter tricuspid valve repair was found to be safe and effective in treating significant TR in a diverse, real-world population. (An Observational Real-World Study Evaluating Severe Tricuspid Regurgitation Patients Treated With the Abbott TriClip™ Device [bRIGHT]; NCT04483089).

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