Work

Management and Outcome of Failed Transcatheter Tricuspid Edge-to-Edge Repair: Insights From the FATE International Registry.

Type: article

Abstract: Background Tricuspid regurgitation (TR) is linked to significant morbidity and mortality. Tricuspid transcatheter edge-to-edge repair (T-TEER) provides a less invasive option for high-risk patients, but real-world data on device failure mechanisms and outcomes remain limited.Objectives The aim of this study was to investigate the incidence, management, and outcomes of T-TEER device-related failures due to loss of leaflet insertion, single-leaflet device attachment, or device embolization, offering insights into these adverse events.Methods The retrospective, multicenter FATE (Failed Tricuspid Transcatheter Edge-to-Edge) registry identified all device-related failures associated with moderate or greater residual or recurrent TR among 2,278 consecutive T-TEER procedures performed at 31 centers from 2017 to 2024. Failure mechanisms were classified by multiparametric echocardiography. Coprimary endpoints were the incidence and management of device-related failure and the composite of death or heart failure rehospitalization.Results Among 2,278 T-TEER procedures, 123 device-related failures (5.4%) were identified (loss of leaflet insertion, 24%; single-leaflet device attachment, 75%; embolization, 1%), mostly diagnosed early and associated with severe or greater TR in 73%. Management was medical therapy in 54% and reintervention in 46%. Reintervention achieved greater TR reduction and right atrial reverse remodeling than medical therapy, but over a median follow-up period of 255 days, the composite of death or heart failure rehospitalization remained frequent (38.2%) and did not differ between strategies. Higher TRI-SCORE, acute kidney injury, and greater discharge TR severity independently predicted adverse outcomes.Conclusions Device-related failure after T-TEER is uncommon but clinically relevant. Reintervention achieves greater TR reduction and right atrial reverse remodeling than medical therapy, but events remain similar between both strategies.

Source: Publikationen an der Universität Bielefeld (Universität Bielefeld)

DOI: 10.48620/96478

Authors: De Marco, Federico, Calamita, Gianmaria, Ardizzone, Valentina, Winkel, Mirjam Gauri, Kassar, Mohammad, Praz, Fabien Daniel, Van Mieghem, Nicolas M, Ooms, Joris F W, Gerçek, Muhammed, Rudolph, Felix, Adamo, Marianna, Coisne, Augustin, Arlanda, Jérémie, Lurz, Philipp, Estévez-Loureiro, Rodrigo, Fam, Neil P, Schofer, Joachim, Brinkmann, Christina, Urena, Marina, Ducrocq, Gregory, Sinning, Jan-Malte, Geisler, Tobias, Azzano, Alessia, Brscic, Elvis, Millin, Antonella, Latib, Azeem, Taramasso, Maurizio, Rubbio, Antonio Popolo, Bedogni, Francesco, Brunner, Stephanie, Toggweiler, Stefan, Swaans, Martin J, Timmers, Leo, Giannini, Francesco, Ielasi, Alfonso, Oliva, Omar, Dumonteil, Nicolas, Tchetchè, Didier, Arzamendi, Dabit, Maisero, Giulia, Tarantini, Giuseppe, Crimi, Gabriele, Porto, Italo, Castriota, Fausto, Ferri, Luca, Montorfano, Matteo, Sticchi, Alessandro, Lopez-Laporte, Maria, Messika-Zeitoun, David, Labinaz, Marino, Lüdike, Peter, Sievert, Horst, Antonelli, Giulia, Fazzari, Fabio, Ferrari, Cristina, Mangieri, Antonio

Language: English

Topic: Cardiac Valve Diseases and Treatments

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

OpenAlex ID: W7141048245

Cites:

Cited by:

Related to: