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

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 TriClipTM 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 & PLUSMN; 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 im-plantation occurred in 99% of subjects, and TR was reduced to & BULL;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 & PLUSMN; 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 & BULL;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 TriClipTM Device [bRIGHT]; NCT04483089) (J Am Coll Cardiol 2023;82:281-291)& COPY; 2023 The Authors. Published by Elsevier on behalf of the American College of Cardiology Foundation. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

Automated summary

This study aimed to investigate the acute outcomes of tricuspid transcatheter edge-to-edge repair with the TriClip system in a real-world setting. Successful reduction of tricuspid regurgitation to a moderate degree was achieved, and there were significant improvements in patients' quality of life and functional status at 30 days. This study demonstrates the safety and efficacy of transcatheter tricuspid valve repair for severe tricuspid regurgitation in diverse patient populations.