Kaya Zeynettin, Polat Fuat, İyigün Ufuk, Süleymanoğlu Cuma, Arslan Gamze Yeter, Ateş İsmail
Department of Cardiology, ASV Yaşam Hospital, Antalya, Turkey.
Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Educatıon Research Hospıtal, Selimiye Mah. Tıbbiye Cad. No.25, Üsküdar/Istanbul, Turkey.
Cardiovasc Drugs Ther. 2025 Sep 16. doi: 10.1007/s10557-025-07775-1.
This study aimed to evaluate the safety and efficacy of transcatheter tricuspid valve repair using the TriClip system in patients with severe tricuspid regurgitation (TR) and large coaptation gaps (> 10 mm), a subgroup traditionally considered anatomically challenging for edge-to-edge repair.
A retrospective analysis was conducted on 9 symptomatic patients who underwent TriClip implantation at multiple centers in Turkey between March 2024 and May 2025. All patients had severe or greater TR with coaptation gaps exceeding 10 mm and were deemed high-risk for surgical intervention. Clinical and echocardiographic parameters were collected before and after the procedure.
The mean age of patients was 68.4 ± 8.6 years. The average coaptation gap was 17.56 ± 3.43 mm. The procedure achieved 100% technical success, defined as at least a one-grade reduction in TR severity. The mean number of clips implanted was 3.22 ± 0.83, with the XTW clip used in 86.3% of cases. No major complications or in-hospital mortality occurred. Symptomatic improvement was observed in all patients, with most experiencing at least one New York Heart Association (NYHA) class reduction. Mean follow-up duration was 6.7 ± 2.4 months.
TriClip repair appears to be a safe and effective therapeutic option in high-risk patients with severe TR and large coaptation gaps. Despite anatomical complexity, significant reductions in TR severity and clinical symptoms were achieved, with low complication rates. These findings support the feasibility of TriClip therapy in this challenging patient population.
本研究旨在评估使用TriClip系统对严重三尖瓣反流（TR）且瓣叶对合间隙较大（>10mm）的患者进行经导管三尖瓣修复的安全性和有效性，这一亚组患者传统上被认为在进行边缘对边缘修复时解剖结构具有挑战性。
对2024年3月至2025年5月在土耳其多个中心接受TriClip植入术的9例有症状患者进行回顾性分析。所有患者均有严重或更严重的TR，瓣叶对合间隙超过10mm，且被认为手术干预风险高。在手术前后收集临床和超声心动图参数。
患者的平均年龄为68.4±8.6岁。平均瓣叶对合间隙为17.56±3.43mm。手术取得了100%的技术成功，定义为TR严重程度至少降低一级。平均植入夹子数量为3.22±0.83个，86.3%的病例使用了XTW夹子。未发生重大并发症或院内死亡。所有患者均观察到症状改善，大多数患者纽约心脏协会（NYHA）心功能分级至少降低一级。平均随访时间为6.7±2.4个月。
对于有严重TR且瓣叶对合间隙较大的高危患者，TriClip修复似乎是一种安全有效的治疗选择。尽管解剖结构复杂，但TR严重程度和临床症状均显著降低，并发症发生率低。这些发现支持了TriClip治疗在这一具有挑战性的患者群体中的可行性。
