Transcatheter Edge-to-Edge Repair for Tricuspid Regurgitation – Initial Experience from an Irish Centre

Abstract

Tricuspid regurgitation (TR), primarily secondary in aetiology, is a strong independent predictor of mortality. Transcatheter edge-to-edge repair (TEER) offers a promising option for patients with severe TR at high or prohibitive surgical risk. We report initial procedural and in-hospital outcomes of TEER at our centre. Between April 2022 and April 2025, 32 patients underwent TV TEER. Baseline clinical, echocardiographic, and procedural data were retrospectively recorded in a dedicated registry. The cohort had a mean age of 81.4 ± 6.5 years; 21 patients (66%) were female. All had permanent atrial fibrillation. TR was secondary in 31 patients (97%)—most commonly due to atrial fibrillation (24; 75%), followed by left heart disease (4; 13%) and pulmonary causes (3; 9%); 1 patient (3%) had primary TR. TR severity was severe in 15 (47%), massive in 7 (22%), and torrential in 10 (31%). A device was successfully implanted in 29 patients (91%). The Edwards Pascal and Abbott TriClip systems were used in 24 (83%) and 5 (17%) of those patients, respectively. The median number of devices per case was 2. The most common deployment involved clips placed between the antero-septal and postero-septal leaflets. Among implanted patients, 26 (90%) had a ≥2-grade TR reduction and 24 (83%) had moderate or less residual TR. In the full cohort, 81% achieved a ≥2-grade reduction and 75% had moderate or less TR. Mean procedure time was 116 ± 48 minutes, and the median hospital stay was 5 days (IQR 4–7). No procedural or in-hospital complications or deaths occurred. TV TEER is feasible, safe, and associated with high procedural success in appropriately selected patients.