Transcatheter therapy offers a promise for a largely forgotten valve given the lack of therapeutic options.
Percutaneous edge-to-edge repair with clip seems to offer some hope to patients with tricuspid regurgitation according to the TRILUMINATE.
At 30 days, transcatheter repair with clip significantly reduced tricuspid regurgitation at least in one grade in most patients, which lead to improved quality of life and functional class.
The lead researcher in this recent study (Dr G Nickening), who presented its outcomes in Paris, stated that its feasibility outcomes (specifically improved cardiac failure symptoms and quality of life) are clinically effective.
Edge-to-edge repair could be a promising alternative that should obviously be tested in randomized studies with harder end points in patients with severe tricuspid regurgitation.
According to the author, tricuspid regurgitation is as prevalent as mitral regurgitation and is associated with bad prognosis. In addition, there are few therapeutic options, diuretics or high-risk surgery.
The TRILUMINATE tested the TriClip, a transcatheter repair system that is just a modified MitraClip NT.
This prospective study was carried out in 21 centers across USA and Europe, including a total 85 patients with moderate or greater tricuspid regurgitation that had no indication for correction of other valves.
Mean age was 78, 33% had prior mitral valve repair and 75% were in functional class III/IV.
Most of these patients had a history of myocardial or valve replacement surgery, which meant going back to surgery for the tricuspid valve involved close to 20% mortality risk.
All devices were successfully implanted in mean 75 minutes. Most clips were attached to the anteroseptal commissure. Nearly half received 2 clips and some up to 4.
At 30 days, el 86.6% of patients improved tricuspid regurgitation at least one grade, reaching efficacy end-point.
Original Title: Percutaneous edge-to-edge repair for tricuspid regurgitation: primary outcomes from the TRILUMINATE clinical trial.
Presenter: Nickenig G.
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