Journal of the American College of Cardiology (JACC)Real-World 1-Year Results of Tricuspid TEER

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The bRIGHT study, a prospective, multicenter post-market registry, offers valuable insights into the real-world outcomes of tricuspid transcatheter edge-to-edge repair (T-TEER) using the TriClip system. This study, involving 511 patients across 26 European sites, demonstrates sustained improvements in tricuspid regurgitation (TR) severity and quality of life at one year post-procedure. The findings suggest potential clinical benefits for patients with severe symptomatic TR, particularly those who achieve a reduction to moderate or less TR within 30 days of the procedure.

Key Points:

• Patient demographics: Subjects were elderly (mean age 79 ± 7 years) with significant comorbidities; 88% had baseline massive or torrential TR, and 80% had NYHA class III/IV symptoms.
• TR reduction: 81% of patients achieved moderate or less TR at one year post-procedure.
• Functional improvements: Significant increases in NYHA class I/II (21% to 75%, p < 0.0001) and Kansas City Cardiomyopathy Questionnaire scores (19 ± 26-point improvement, p < 0.0001) were observed at one year.
• Mortality associations: Lower one-year mortality was associated with achieving moderate or less TR at 30 days, lower baseline serum creatinine, and higher baseline right ventricular tricuspid annular plane systolic excursion.
• Safety profile: The TriClip system demonstrated a favorable safety profile through one year of follow-up.
• Real-world applicability: The bRIGHT registry included patients with more advanced disease compared to previous trials, suggesting broader clinical applicability.

HCN Medical Memo
The bRIGHT study provides compelling evidence for the potential of T-TEER as a treatment option for severe symptomatic tricuspid regurgitation. The sustained TR reduction and quality of life improvements observed at one year suggest that this minimally invasive approach may offer significant benefits for carefully selected patients, particularly those with limited surgical options.

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