Combined M-TEER and T-TEER using a single TriClip guide catheter achieved 100% implantation success, safe procedures, and sustained MR ≤2+ in all patients at 1 year.
Does combined M-TEER and T-TEER using a single TriClip steerable guide catheter improve MR and TR severity and functional outcomes in patients with severe MR and TR?
Combined M-TEER and T-TEER using a single TriClip steerable guide catheter is safe and effectively reduces MR and TR severity while improving functional status.
Absolute Event Rate: 0% vs 0%
Abstract Background Concomitant transcatheter mitral (M-TEER) and tricuspid (T-TEER) edge-to-edge repair has emerged as a promising treatment for severe mitral (MR) and tricuspid regurgitation (TR). Purpose While prior studies utilized two separate systems, this study evaluates the outcomes of combined M-TEER and T-TEER using a single steerable guide catheter (SGC) of the TriClip system, comparing elderly (≥75 years) and younger patients (75 years), as well as degenerative (DMR) and functional MR (FMR). Methods Patients with moderate-to-severe (3+) or severe (4+) DMR or FMR and severe functional TR (NYHA class III/IV) who underwent combined M-TEER and T-TEER with the TriClip SGC between January 2022 and December 2024 were included. Propensity score matching minimized baseline differences between age and etiology groups. Outcomes included procedural outcomes, MR and TR severity reduction, and NYHA class improvement. A two-way repeated-measures ANOVA assessed the effects of age, MR etiology, and time on outcomes, with post hoc tests identifying time-specific differences. Results Among 42 patients (18 matched pairs, 64% female, median age 77 years IQR: 9), the implantation success rate was 100%. Median device and procedure times were 39.2 ± 6.9 minutes and 71.2 ± 9.6 minutes, respectively. Mean hospital stay was 2.9 ± 0.2 days, with no in-hospital or 30-day major adverse events (MAEs), except for tricuspid single leaflet device attachment (SLDA) in 2 patients (4.8%) and atrial septal defect (ASD) closure in 1 patient (2.4%). During a median follow-up of 0.81 years, heart failure hospitalization rate was 7.1%, with no deaths. At 30 days and 1 year, MR ≤2+ was achieved in all patients, with 71.4% showing only mild MR at 1 year. Repeated-measures ANOVA revealed significant reductions in MR severity over time (p 0.001), consistent across age (p = 0.67) and MR etiology subgroups (p = 0.09). TR severity also improved significantly, with 74% and 21% of patients achieving only trivial or mild TR at 1 year, respectively (p 0.001). Post hoc analysis confirmed sustained improvements from baseline to follow-up (p 0.001), unaffected by age (p = 0.69) or MR etiology (p = 0.88) in matched cohort. Functional outcomes also improved, with all patients achieving NYHA class I/II at 1 year and 31% remaining asymptomatic since 30 days. Repeated-measures ANOVA confirmed significant NYHA improvement over time (p 0.001), unaffected by age (p = 0.55), MR etiology (p = 0.78), or their interactions with time. Post hoc tests showed sustained improvement from baseline to 30 days and 1 year (both p 0.001). Conclusions Combined M-TEER and T-TEER using a single TriClip® SGC demonstrated excellent safety, echocardiographic, and functional improvements at 30 days and 1 year, across diverse subgroups, providing a reliable strategy for addressing complex multi-valve pathologies with minimal procedural risk.Figure 1
Papadopoulos et al. (Sat,) reported a other. Combined M-TEER and T-TEER using a single TriClip guide catheter achieved 100% implantation success, safe procedures, and sustained MR ≤2+ in all patients at 1 year.