title: Transcatheter treatment of severe tricuspid regurgitation using the edge-to-edge repair technique.
abstract: OBJECTIVE
  The aim of this study was to investigate the procedural feasibility and short-term durability of the transcatheter tricuspid valve edge-to-edge repair technique in highly symptomatic patients with severe tricuspid regurgitation (TR).
  
  
  RESULTS
  Eighteen consecutive patients suffering from severe right-sided heart failure (NYHA Class III-IV), primarily due to moderate to severe tricuspid regurgitation, were included in the study. Applying a modified steering technique for the clip delivery system, six patients were treated for isolated severe TR, while 12 patients were treated for moderate to severe TR and concomitant severe mitral regurgitation. The primary objectives were procedural success, defined as reduction of at least one TR grade, and 30-day echocardiographic and clinical outcomes. A total of 41 clips (2.3±0.7 per patient) were placed into the tricuspid valve of high surgical risk patients (EuroSCORE II: 10±8%). Procedural success was achieved in all patients; no MACCE occurred in hospital. The presence of a TR grade ≥3 was reduced from 94% (17 patients) before the procedure to 33% (six patients) at 30-day follow-up (p<0.001). Sixteen patients (89%) reported an improvement in NYHA functional class at 30 days.
  
  
  CONCLUSIONS
  Applying a modified steering technique, the edge-to-edge repair technique can be successfully used for the treatment of TR. At 30-day follow-up, the short-term durability of TR reduction appeared promising and the majority of patients improved clinically. Further studies with larger patient populations and longer follow-up have to define the role of this novel treatment option for patients with right-sided heart failure and severe TR.
authors.affiliation: Medizinische Klinik und Poliklinik I, Klinikum der Universität München, Munich, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Braun
authors.forename: Michael
authors.initials: M
authors.lastname: Nabauer
authors.forename: Mathias
authors.initials: M
authors.lastname: Orban
authors.forename: Martin
authors.initials: M
authors.lastname: Orban
authors.forename: Lisa
authors.initials: L
authors.lastname: Gross
authors.forename: Andrea
authors.initials: A
authors.lastname: Englmaier
authors.forename: Diana
authors.initials: D
authors.lastname: Rösler
authors.forename: Julinda
authors.initials: J
authors.lastname: Mehilli
authors.forename: Axel
authors.initials: A
authors.lastname: Bauer
authors.forename: Christian
authors.initials: C
authors.lastname: Hagl
authors.forename: Steffen
authors.initials: S
authors.lastname: Massberg
authors.forename: Jörg
authors.initials: J
authors.lastname: Hausleiter
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004452:Echocardiography / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000209:etiology; D019918:Heart Valve Prosthesis Implantation / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000601:surgery*; D016896:Treatment Outcome; D014262:Tricuspid Valve Insufficiency / Q000601:surgery*