Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, İstanbul, Türkiye.
Department of Cardiology, Antalya ASV Yaşam Hospital, Antalya, Türkiye.
Turk Kardiyol Dern Ars. 2024 Sep;52(6):375-383. doi: 10.5543/tkda.2024.34954.
This study aims to assess the efficacy and safety of tricuspid valve (TV) transcatheter edge-to-edge repair (TEER) procedures using the MitraClip or TriClip device in high-risk patients with severe secondary tricuspid regurgitation (TR) and provide Turkish-specific data on procedural outcomes and clinical follow-up.
This study enrolled 42 high-risk patients with severe secondary TR who underwent transcatheter edge-to-edge repair using either the MitraClip or TriClip device. Patient selection criteria included severe TR, high surgical risk (EuroScore ≥ 8 and Tricuspid Regurgitation Impact Severity Score (TRI-SCORE) ≥ 6), symptomatic despite medical therapy, and anatomical suitability for TriClip. Patients underwent rigorous evaluation by a specialized cardiac team before the procedure, including 2D/3D transesophageal echocardiography to assess eligibility.
The study achieved a 100% procedural success rate, defined as successful implantation and at least one-degree reduction in TR severity. Post-procedure assessments revealed that 88.1% of patients had mild to moderate TR, indicating significant improvement, while only 11.9% retained severe TR. During the median follow-up of 11.5 months, rehospitalization occurred in 23.8% of patients, and mortality was observed in 7.1% of patients, demonstrating a favorable safety profile. Comparative analysis between TriClip and MitraClip devices showed similar efficacy and safety outcomes, with no significant differences in procedural durations or complication rates.
The study demonstrates the effectiveness and safety of TV TEER using TriClip or MitraClip devices in managing severe secondary TR in high-risk patients. Procedure success, improved TR severity, and favorable clinical outcomes were observed, supporting the role of transcatheter techniques in TR management.
本研究旨在评估使用 MitraClip 或 TriClip 装置进行三尖瓣（TV）经导管缘对缘修复（TEER）手术在高危、严重继发性三尖瓣反流（TR）患者中的疗效和安全性，并提供土耳其特定的手术结果和临床随访数据。
本研究纳入了 42 例高危、严重继发性 TR 患者，这些患者接受了 MitraClip 或 TriClip 装置的经导管缘对缘修复。患者选择标准包括严重 TR、高手术风险（EuroScore≥8 和三尖瓣反流影响严重程度评分（TRI-SCORE）≥6）、尽管接受了药物治疗仍有症状以及 TriClip 解剖学适宜性。患者在术前由专门的心脏团队进行了严格的评估，包括 2D/3D 经食管超声心动图以评估是否符合入选条件。
研究达到了 100%的手术成功率，定义为成功植入和至少一个等级的 TR 严重程度降低。术后评估显示，88.1%的患者 TR 为轻度至中度，表明显著改善，而只有 11.9%的患者仍为严重 TR。在 11.5 个月的中位随访期间，23.8%的患者需要再次住院治疗，7.1%的患者死亡，表明安全性良好。TriClip 和 MitraClip 装置之间的比较分析显示出相似的疗效和安全性结果，手术持续时间和并发症发生率无显著差异。
本研究表明，使用 TriClip 或 MitraClip 装置进行 TV TEER 在高危、严重继发性 TR 患者中是有效且安全的。观察到手术成功、TR 严重程度改善和良好的临床结局，支持经导管技术在 TR 管理中的作用。
