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March 25, 2026Clinical Research in CardiologyOpen Access

Outcomes of transcatheter edge-to-edge repair versus transcatheter valve replacement with the cardiovalve system for tricuspid regurgitation

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Why the study?

Surgical treatment of tricuspid regurgitation carries high risk in elderly, multimorbid patients, prompting the development and need to compare less invasive therapies like T-TEER and TTVR.

Does transcatheter tricuspid valve replacement compared to transcatheter edge-to-edge repair improve outcomes in high-risk patients with severe tricuspid regurgitation?

Comparison

T-TEER vs TTVR

Design

Comparative observational study

Follow-up

30 days

Key result

Transcatheter tricuspid valve replacement achieved a significantly greater reduction of tricuspid regurgitation to grade 0/I compared to edge-to-edge repair (80% vs 44.9%, p<0.001) at 30 days.

Authors

CMChristoph MarquetandVSVanessa SoltauBFBuntaro Fujita

Discussion

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Overview

Higher bleeding with TTVR warrants caution in high-risk patients; leaves open net benefit versus T-TEER pending randomized trials.

Key Points

  • The aim is to compare the 30-day clinical and echocardiographic outcomes of T-TEER and TTVR in high-risk patients with severe TR.
  • Conducted in 114 high-risk patients, with 104 undergoing T-TEER and 10 undergoing TTVR.
  • Procedures guided by transesophageal echocardiography and fluoroscopy.
  • Primary endpoints included TR reduction, NYHA functional class, and safety events based on TVARC criteria.
  • TR reduction to grade 0/I was 44.9% in the T-TEER group and 80% in the TTVR group (p < 0.001).
  • NYHA class I/II was achieved in 63.2% after T-TEER and 70% post-TTVR (p = 0.69).
  • Major bleeding was more common in the TTVR group (20%) compared to T-TEER (1.96%; p = 0.041).
  • No deaths, strokes, or surgical conversions occurred in either group.

Study Design

Type

Observational (n=114)

Multicenter

No

Structured PICO

Does transcatheter tricuspid valve replacement compared to transcatheter edge-to-edge repair improve outcomes in high-risk patients with severe tricuspid regurgitation?

P
Population
High-risk patients with severe tricuspid regurgitation (TR) deemed inoperable or high-risk by the local heart team
I
Intervention
Transcatheter tricuspid valve replacement (TTVR) using the Cardiovalve system
C
Comparator
Transcatheter tricuspid edge-to-edge repair (T-TEER) using TriClip or PASCAL
O
Outcome
TR reduction, NYHA functional class, and safety events according to TVARC criteria at 30 dayscomposite

Main Result

Absolute Event Rate: 80% vs 44.9%

p-value: p=<0.001

TTVR achieves greater short-term tricuspid regurgitation reduction than T-TEER in high-risk patients, but is associated with a higher risk of access site bleeding.

Limitations

  • Retrospective monocentric analysis without randomization
  • Small sample size, particularly in the TTVR group (n=10)
  • Short follow-up period of 30 days
  • Small sample size
  • Retrospective observational design
  • Short follow-up period (30 days)

Cite This Study

Marquetand et al. (2026) conducted an observational in Severe tricuspid regurgitation (n=114). Transcatheter tricuspid valve replacement (TTVR) vs. Transcatheter tricuspid edge-to-edge repair (T-TEER) was evaluated on Tricuspid regurgitation reduction to grade 0/I at 30 days (p=<0.001). Transcatheter tricuspid valve replacement achieved a significantly greater reduction of tricuspid regurgitation to grade 0/I compared to edge-to-edge repair (80% vs 44.9%, p<0.001) at 30 days.

synapsesocial.com/papers/69c37ba2b34aaaeb1a67e41fhttps://doi.org/10.1007/s00392-026-02867-w
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