Initial Real-World Experience of Tricuspid Transcatheter Edge-to-Edge Repair in Asia

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BACKGROUND: Tricuspid regurgitation (TR) causes significant morbidity. Transcatheter edge-to-edge repair (TEER) has been proven effective in relieving TR symptoms. Access to tricuspid TEER and the associated experience are limited in Asia. OBJECTIVES: This study aimed to summarize the initial experience with the tricuspid TEER system (Abbott) in Asia. METHODS: Patients undergoing tricuspid TEER (Abbott) from 2017 to 2024 were enrolled from 4 centers in Asia. The primary endpoint was device success (TR ≤moderate) at 30 days. Secondary endpoints included inpatient complications, 30-day NYHA functional class, and 30-day major adverse events. Risk factors for 30-day device success were identified. RESULTS: A total of 106 patients were included, with a mean age of 76.1 ± 10 years, and 88.7% (n = 94 of 106) had atrial fibrillation. Most TR cases treated were functional (88.7% [n = 94 of 106]), with over half classified as massive or torrential (56.6% [n = 60 of 106]). Tricuspid TEER was performed using off-label MitraClip in 22.6% (n = 24), while the remaining 77.4% (n = 82) utilized TriClip. Combined procedures (with mitral TEER and others) were common (47.2% [n = 50 of 106]). At 30 days, 74.0% (n = 77 of 104) achieved device success (TR ≤moderate), and 95.2% (n = 99 of 104) experienced at least a 1-grade TR reduction. Additionally, 96.2% (n = 100 of 104) were NYHA functional class I/II, and major adverse events were 1.9% (n = 2 of 106) at 30 days. Baseline nontorrential TR and increased clinical experience (second half of cases) were associated with 30-day device success (P = 0.010 and P = 0.044, respectively). CONCLUSIONS: The early experience with tricuspid TEER in Asia is promising, demonstrating a reasonable device success rate and a high safety profile. Clinical experience is associated with improved device success.

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