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Outcomes of Tricuspid Transcatheter Edge-to-edge Repair in Subjects with Endocardial Leads

Abstract

Background: Transcatheter edge-to-edge repair (TEER) using the TriClip tricuspid valve repair system has emerged as a therapy for tricuspid regurgitation (TR). Patients with TR undergoing TEER commonly present with an endocardial lead across the tricuspid valve (TV).

Aims: We sought to examine the effectiveness and safety of tricuspid TEER (T-TEER) in subjects with endocardial leads in the bRIGHT EU Post-Approval Study (PAS).

Methods: The bRIGHT EU PAS is a prospective, single-arm, open-label, multicentre, post-market registry conducted at 26 sites in Europe. Echocardiographic assessments of endocardial lead placement, interaction, and TR grade were performed at a core laboratory.

Results: Of the 511 enrolled subjects, a total of 110 had an endocardial lead, and in 80.7% of these subjects, TR was at least partially related to the lead. At 30 days, 71% of subjects with endocardial leads had TR of moderate or less. The percentage of subjects with endocardial leads categorised as New York Heart Association Functional Class I-II increased from 17% at baseline to 75% at 30 days (p<0.0001), and quality of life with the Kansas City Cardiomyopathy Questionnaire showed a mean improvement of 20±24 points from baseline to 30 days (p<0.0001). T-TEER was safe in subjects with endocardial leads, with similar rates of events, including TV reintervention/reoperation and TV surgery, to those in subjects without leads. No reports of lead malfunction were reported.

Conclusions: In the bRIGHT EU PAS, T-TEER using the TriClip system was safe and effective in severe TR subjects with an endocardial lead across the TV.

References
1.
Hahn R, Zamorano J . The need for a new tricuspid regurgitation grading scheme. Eur Heart J Cardiovasc Imaging. 2017; 18(12):1342-1343. DOI: 10.1093/ehjci/jex139. View

2.
Ruf T, Hahn R, Kreidel F, Beiras-Fernandez A, Hell M, Gerdes P . Short-Term Clinical Outcomes of Transcatheter Tricuspid Valve Repair With the Third-Generation MitraClip XTR System. JACC Cardiovasc Interv. 2021; 14(11):1231-1240. DOI: 10.1016/j.jcin.2021.03.033. View

3.
Fam N, Samargandy S, Gandhi S, Eckstein J . Intracardiac echocardiography for guidance of transcatheter tricuspid edge-to-edge repair. EuroIntervention. 2018; 14(9):e1004-e1005. DOI: 10.4244/EIJ-D-18-00672. View

4.
Lurz P, Besler C, Schmitz T, Bekeredjian R, Nickenig G, Mollmann H . Short-Term Outcomes of Tricuspid Edge-to-Edge Repair in Clinical Practice. J Am Coll Cardiol. 2023; 82(4):281-291. DOI: 10.1016/j.jacc.2023.05.008. View

5.
Praz F, Muraru D, Kreidel F, Lurz P, Hahn R, Delgado V . Transcatheter treatment for tricuspid valve disease. EuroIntervention. 2021; 17(10):791-808. PMC: 9724890. DOI: 10.4244/EIJ-D-21-00695. View