Transcatheter tricuspid valve replacement after failed edge-to-edge repair
Year: 2026
Type: article
Abstract: BACKGROUND: Residual or recurrent tricuspid regurgitation (TR) after transcatheter edge-to-edge repair (TEER) is a growing concern in clinical practice and is associated with inferior outcomes. AIMS: We sought to evaluate the early experience of transcatheter tricuspid valve replacement (TTVR) in patients with failed TEER. METHODS: This multicentre, retrospective cohort study included patients undergoing TTVR for recurrent or residual severe TR after TEER. Clinical, echocardiographic, and computed tomography findings were evaluated. The primary outcome was clinical success at 30 days after TTVR. RESULTS: Of the 28 patients included (age 78.5±6.3 years, 61% female), 20 (72%) had residual TR and 8 (28%) had recurrent TR diagnosed within a median of 182 days after TEER. Patients were severely symptomatic (New York Heart Association [NYHA] III/IV in 97%), and 64% had massive/torrential TR. In 6 patients (21%), a commissural TEER device was evident, enabling direct TTVR (neocommissure strategy). Engagement of TEER devices with single leaflet device attachment during TTVR was carried out in 12 patients (43%), and electrosurgical laceration and stabilisation to facilitate TTVR in 10 patients (36%). Clinical success at 30 days was 93%. NYHA Functional Class improved in 93% of patients, with 85% being in NYHA I/II at 1 month after TTVR. Two patients died from non-cardiac reasons, and during a median follow-up of 69 days, 4 patients suffered a heart failure hospitalisation despite procedural success. CONCLUSIONS: In this small patient cohort, three different TTVR strategies after failed TEER resulted in significant clinical success at 30 days and led to substantial symptom relief during short-term follow-up.
Source: EuroIntervention
Authors: Christian Besler, Philipp Emanuel Bartko, Federico De Marco, Marco Costa, Tobias Geisler, Christian Frerker, Matti Adam, Tobias Ruf, Tobias Kister, Stefan Toggweiler, Dennis Mehrkens, Luis Paiva, Charlotte Jantsch, Tim Seidler, Pierre Deharo, Rui Campante Teles, Regina Rebeiras, Fabian Voss, Mirjam G. Wild, Aleksandre Tarkhnishvili, Robin Le Ruz, Philipp Lurz, Dirk Westermann, Amin Polzin
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7225612875