TTVR improves outcomes for patients with severe tricuspid regurgitation
Transcatheter edge-to-edge tricuspid valve repair (TTVR) is an effective treatment option for patients with severe tricuspid regurgitation (TR), according to a new study published in JACC: Heart Failure. TTVR was found to reduce hospitalization for heart failure (HHF) and lead to better patient outcomes.
“Severe TR is an unsolved clinical challenge in patients at prohibitive or high surgical risk and is associated with poor prognosis,” wrote first author Mathias Orban, MD, of the Munich Heart Alliance in Germany, and colleagues. “The mutuality of secondary TR, tricuspid valve annular dilatation, and right ventricular (RV) dysfunction causes right-sided heart failure (HF) with repeat hospitalizations.”
Orban et al. studied data from 119 TTVR patients who received treatment from Dec. 1, 2015, to Dec. 3, 2018, at academic medical centers in Germany, Switzerland or Canada. Data was also collected on patients who received combined transcatheter mitral and tricuspid valve repair (TMTVR) during the same time period, allowing the researchers to make direct comparisons.
Overall, TTVR led to a reduction from severe TR to moderate TR or less for 82% of patients. After a median follow-up period of 360 days, a reduction to moderate TR or less remained for 72% of patients. Also, TTVR led to a reduction in HHF of 22%. Successful TTVR was associated with boosts in both one-year survival and event-free-survival.
“Interventional tricuspid valve repair is a promising therapeutic option in patients with severe TR,” the authors concluded. “With growing experience and adapted device design, long-term success could be further improved. Randomized trials comparing interventional tricuspid valve repair versus optimal medical therapy in patients ineligible or at high risk for surgery should be performed to confirm this finding.”