Transcatheter edge-to-edge repair of tricuspid valve regurgitation in systemic right ventricle: Echocardiographic outcome

Abstract

Background

Transcatheter edge-to-edge repair (TEER) provides an alternative option for high risk patients with systemic tricuspid regurgitation (STR). Preliminary data of the French study has shown its feasibility and safety, but mid-term echocardiographic outcome is lacking.

Objectives

Echocardiographic outcome of TEER in systemic tricuspid regurgitation.

Methods

TEER French cohort is a multicentre, longitudinal, descriptive, prospective study of patients undergoing TEER for severe STR. 20 patients with severe or greater STR undergoing percutaneous repair with the MitraClip system were enrolled in the study between May 2019 and November 2024. A transthoracic echocardiography was performed at baseline, six months, one year and two years after the procedure. TR was assessed using standard 2-dimensional color Doppler methods and graded TR using the 5-class grading scheme: mild, moderate, severe, massive, and torrential. The number of clips and their localization was analyzed.

Results

A reduction of at least 1 grade in TR was achieved in all subjects. TR grade remained moderate or less in 83% of patients at 2-years follow-up. TR reduction was sustained at 2-years follow-up for all patients. Among 14 patients, 5 patients had one-clip implantation, and 9 patients had two or more clips implantation. TR grade seemed to be lower in the group of patient with 2 or more clips strategy: TR was mild in 67% of patients in 2 or more clips group and moderate in 100% of patients in 1-clip group.

Conclusion

TEER of systemic tricuspid regurgitation is found to be safe and effective, with sustained effects at 2 years in patients. Patients with two or more clips implantation seem to have a better outcome in the regurgitation grade, but additional data and a bigger cohort are needed to predict the outcome and define the optimal technical strategy.