Comparison of commercially available tricuspid transcatheter edge-to-edge repair devices in real-world practice: data from EuroTR
L Stolz, N K Karam, J H HausleiterAbstract
Background
Transcatheter tricuspid valve edge-to-edge repair (T-TEER) has developed as a treatment option for patients presenting with severe tricuspid regurgitation (TR) at prohibitive surgical risk. While two T-TEER devices are commercially available in Europe, their efficacy has not been compared.
Objective
To compare procedural performance, durability of TR reduction, and clinical outcomes according to T-TEER device.
Methods
Data were taken from the EuroTR (European Registry of Transcatheter Intervention for Tricuspid Regurgitation) registry and included patients undergoing T-TEER in 26 European centers between 2016 and 2024. Characteristics and outcomes of patients were compared at discharge and latest follow-up, according to the device used, in the global population and after propensity score matching.
Results
Overall, 1,814 consecutive patients treated with T-TEER were included (824 with TriClip and 990 with PASCAL). After propensity matching creating two balanced groups of 713 patients each, improvement in TR was observed in both groups with similar rates of residual TR≤2+ at discharge and follow-up (82.7% vs. 84.7%, p=0.456; and: 64.6% vs. 71.6%, p=0.093; for TriClip vs. PASCAL, respectively). Symptomatic improvement at one year was similar in both cohorts (NYHA class ≤ II TriClip vs. PASCAL: 63.7% vs. 62.8%, p=0.833). Significant right ventricular reverse remodeling was observed with both devices (TriClip: difference in right ventricular end-diastolic area from -2.2 [IQR -6.7 to 2.6] cm2, p=0.018, PASCAL: -2.4 [IQR -7.2 to 2.4] cm2, p=0.001). There was no difference in Kaplan–Meier estimates of two-year survival and survival free from heart failure hospitalization (HR 0.90, 95%CI 0.70- 1.71, p=0.444 and HR 1.11, 95%CI 0.90-1.37, p=0.349).
Conclusions
TriClip and PASCAL yielded comparable TR reduction, symptomatic improvement, right ventricular reverse remodeling and two-year survival free from heart failure hospitalizationTwo-year survival stratified by device type