Transcatheter Valve Replacement for Severe Tricuspid Regurgitation

In this international, manufacturer-funded, randomized (2:1) trial (NCT04482062), investigators compared transcatheter tricuspid valve replacement (TTVR) with medical therapy in 400 patients with symptomatic severe tricuspid regurgitation (TR; mean age, 79 years; 76% women). The primary endpoint was a hierarchical composite of death, transplant, surgery, heart failure hospitalization, and improvement in symptoms.

At 30 days, more patients undergoing TTVR died (3.5% vs. 0%), had severe bleeding (10% vs. 2%), or required new pacemakers (25% vs. 0%, among those without a preexisting pacer). At 1 year, the primary endpoint significantly favored TTVR, mostly due to greater symptom improvement (>10-point increase in Kansas City Cardiomyopathy Ques…