Transcatheter repair for tricuspid regurgitation improves quality of life

A new study published in The New England Journal of Medicine suggests that tricuspid transcatheter edge-to-edge repair (TEER) improved quality of life, decreased the severity of tricuspid regurgitation, and was safe for individuals with severe tricuspid regurgitation.

Extreme tricuspid regurgitation is a crippling illness that is frequently linked with a low quality of life and significant morbidity. In people with this condition, reducing tricuspid regurgitation may lessen symptoms and enhance therapeutic results. This study was carried out by Paul Sorajja and colleagues to evaluate the effects of minimizing tricuspid regurgitation in patients.

In order to treat severe tricuspid regurgitation, researchers performed a prospective, randomized study of tricuspid transcatheter edge-to-edge repair. TEER or medicinal treatment (control) was randomly allocated to patients with symptomatic severe tricuspid regurgitation at 65 centers in the United States, Canada, and Europe in a 1:1 ratio. The Kansas City Cardiomyopathy Questionnaire (KCCQ) was used to measure quality of life, with an improvement being defined as an increase of at least 15 points in the KCCQ score at the 1-year follow-up. The primary end point was a hierarchical composite that included death from any cause or tricuspid-valve surgery, hospitalization for heart failure, and hospitalization for heart failure. Safety and the degree of tricuspid regurgitation were also evaluated.

The key findings of this study were:

1. 350 patients in all were recruited, with 175 being placed in each group. The patients were 78 years old on average, and 54.9% of them were female.

2. The TEER group was favored by the findings for the main end goal.

3. Hospitalization rates for heart failure and the frequency of mortality or tricuspid-valve operation did not seem to vary between the groups.

4. In the TEER group, the KCCQ quality of life score increased by a mean (SD) of 12.31.8 points compared to 0.61.8 points in the control group.

5. At 30 days, tricuspid regurgitation was mild to moderate in severity in 87.0% of patients in the TEER group and 4.8% of patients in the control group.

6. 98.3% of the patients who received TEER were free of serious adverse effects after 30 days, proving the technique to be safe.

Reference:

Sorajja, P., Whisenant, B., Hamid, N., Naik, H., Makkar, R., Tadros, P., Price, M. J., Singh, G., Fam, N., Kar, S., Schwartz, J. G., Mehta, S., Bae, R., Sekaran, N., Trusty, P. M., … Adams, D. H. (2023). Transcatheter Repair for Patients with Tricuspid Regurgitation. In New England Journal of Medicine (Vol. 388, Issue 20, pp. 1833–1842). Massachusetts Medical Society. https://doi.org/10.1056/nejmoa2300525