Mid-Term Outcomes and Echocardiographic Predictors of TTVR: Insights from the TRAVEL Study

Background: The mid-term prognosis after transcatheter tricuspid valve replacement (TTVR) is poorly defined, and echocardiographic predictors remain uncertain. Objectives: To describe mid-term all-cause mortality, 30-day major adverse events (MAEs), and echocardiographic risk markers of TTVR. Methods: Consecutive patients undergoing TRAVEL (Transcatheter right atrial-ventricular valve replacement With LuX-Valve) at three centers were retrospectively analyzed. Firth Cox regression was applied for mortality, and Firth logistic regression was used for exploratory MAE analyses. Results: A total of 62 patients (median age 66.5 years [61.0–72.8], 83.8% female) were included. Over a mean follow-up of 46.2 months, seven deaths (11.2%) occurred, corresponding to mid-term survival of 88.8%. Within 30 days, 14 patients (22.6%) experienced MAEs, including three deaths (4.8%), major bleeding in eight (12.9%), surgical re-exploration in seven (11.3%), repeat open-heart tricuspid valve replacement in one (1.6%), and permanent pacemaker implantation in six (9.7%). TR was reduced to mild or less in 95.2% at 1 year. Conclusions: In this LuX-Valve TTVR cohort, 30-day MAEs mainly reflected perioperative or device-related complications rather than a direct signal of baseline RV dysfunction or remodeling. LuX-Valve implantation showed favorable mid-term survival and clinically meaningful procedural effectiveness; RV-centered echocardiographic markers should be considered hypothesis-generating and require validation in larger cohorts.