New research presented at TCT 2019 suggests transcatheter tricuspid valve interventions (TTVI) are associated with greater survival and reduced rehospitalization for heart failure (HF) in patients with symptomatic severe tricuspid regurgitation (TR) compared with medical therapy alone. The findings presented by Maurizio Taramasso, MD, PhD, et al., were also published Sept. 27 in the Journal of the American College of Cardiology.

The study used propensity score matching and identified 268 adequately matched pairs of patients out of a total of 472 patients from 22 European and North American centers who underwent TTVI from 2016 to 2018. The primary endpoint was one-year mortality or HF rehospitalization or the composite.

Compared with controls, results found TTVI patients had lower one-year mortality (23 ±3 percent vs. 36 ±3 percent, p=0.001), rehospitalization (26 ±3 percent vs. 47 ±3 percent p<0.0001), and composite endpoint (32 ±4 percent vs. 49 ±3 percent; p=0.0003). According to Taramasso and colleagues, "TTVI was associated with greater survival and freedom from HF rehospitalization, which remained significant after adjusting for sex, NYHA class, right ventricular dysfunction and atrial fibrillation and after further adjustment for mitral regurgitation and pacemaker/defibrillator."

Researchers recommend future randomized clinical trial to confirm their findings. However, they note: "In absence of randomized trials in the field of treatment of symptomatic severe TR, this study suggests a potential clinical benefit associated with interventional treatment in patients with symptomatic severe TR on top of medical therapy as compared to conservative treatment alone."

In a related editorial comment, Mohamad Alkhouli, MD, FACC, et al., add that "While the current study adds importantly to the field and suggests that TTVI may be a promising approach, it is crucial that ... concepts regarding the underlying disease are not ignored in the midst of the enthusiasm about TTVI."

Clinical Topics: Invasive Cardiovascular Angiography and Intervention, Interventions and Imaging, Angiography, Nuclear Imaging

Keywords: TCT19, Transcatheter Cardiovascular Therapeutics, Angiography

< Back to Listings