Summary
This international real-world cohort study of 3,025 patients undergoing transcatheter tricuspid valve repair across 26 centres (2016–2024) found that T-TEER is safe and effective in 851 patients (28.1%) with transvalvular CIED leads, with stable device function and no required lead revisions. Propensity-matched analysis of 385 pairs showed comparable residual TR burden, functional status and 2-year heart failure hospitalisation-free survival between patients with and without CIEDs, though CIED presence showed a non-significant trend towards increased adverse outcomes. Achieving residual TR ≤2+ was prognostically beneficial irrespective of CIED presence.
Regional applicability
These findings are applicable to UK cardiac interventionalists and device specialists managing high-risk patients with severe tricuspid regurgitation and transvalvular CIED leads. The evidence supports consideration of transcatheter approaches as alternatives to surgery in this complex population within UK National Health Service practice.
Key measures
Residual TR grade at discharge and follow-up; CIED function pre- and post-procedure; all-cause mortality; heart failure hospitalisation at 2 years; need for lead revision
Outcomes reported
The study evaluated procedural safety, residual tricuspid regurgitation (TR) at discharge and follow-up, cardiac implantable electronic device (CIED) function stability, and 2-year all-cause mortality or heart failure hospitalisation rates in patients undergoing transcatheter edge-to-edge tricuspid valve repair (T-TEER) with transvalvular CIED leads.
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