Real-world 1-Year Results of Tricuspid Edge-to-Edge Repair from the bRIGHT Study.

TriClip leaflet repair transcatheter edge-to-edge repair tricuspid regurgitation tricuspid repair

Journal

Journal of the American College of Cardiology
ISSN: 1558-3597
Titre abrégé: J Am Coll Cardiol
Pays: United States
ID NLM: 8301365

Informations de publication

Date de publication:
10 May 2024
Historique:
received: 01 04 2024
revised: 29 04 2024
accepted: 08 05 2024
medline: 18 5 2024
pubmed: 18 5 2024
entrez: 17 5 2024
Statut: aheadofprint

Résumé

Severe tricuspid regurgitation (TR) is known to be associated with poor quality of life and increased risk of death when left untreated. To report the 1-year clinical outcomes of subjects treated by tricuspid transcatheter edge-to-edge repair (TEER) with the TriClip system in a contemporary, real-world setting. The bRIGHT post-approval study is a prospective, single-arm, open-label, multicenter, post-market registry conducted at 26 sites in Europe with central event adjudication and echocardiographic core-lab assessment. Enrolled subjects were elderly (79±7 years) with significant comorbidities. Eighty-eight percent had baseline massive or torrential TR and 80% percent of subjects were in NYHA class III/ IV. TR was reduced to moderate or less in 81% at 1 year. Significant improvements in NYHA class (21% to 75% I/II, P<0.0001) and KCCQ score (19±26-point improvement, P<0.0001) were observed at 1 year. One-year mortality was significantly lower in subjects who achieved moderate or lower TR at 30 days; however, there was no difference in mortality among subjects that achieved moderate, mild, or trace TR at 30 days. In addition to TR reduction at 30 days, baseline serum creatinine and baseline RV TAPSE were independently associated with mortality at 1 year (OR: 2.169, 95% CI: [1.494, 3.147], P<0.0001; OR: 0.636, 95% CI: [0.415, 0.974], P=0.0375). Mortality was not associated with baseline TR grade, nor with center volume. Tricuspid TEER using the TriClip system was safe and effective through 1 year for subjects with significant TR and advanced disease in a diverse, real-world population.

Sections du résumé

BACKGROUND BACKGROUND
Severe tricuspid regurgitation (TR) is known to be associated with poor quality of life and increased risk of death when left untreated.
OBJECTIVES OBJECTIVE
To report the 1-year clinical outcomes of subjects treated by tricuspid transcatheter edge-to-edge repair (TEER) with the TriClip system in a contemporary, real-world setting.
METHODS METHODS
The bRIGHT post-approval study is a prospective, single-arm, open-label, multicenter, post-market registry conducted at 26 sites in Europe with central event adjudication and echocardiographic core-lab assessment.
RESULTS RESULTS
Enrolled subjects were elderly (79±7 years) with significant comorbidities. Eighty-eight percent had baseline massive or torrential TR and 80% percent of subjects were in NYHA class III/ IV. TR was reduced to moderate or less in 81% at 1 year. Significant improvements in NYHA class (21% to 75% I/II, P<0.0001) and KCCQ score (19±26-point improvement, P<0.0001) were observed at 1 year. One-year mortality was significantly lower in subjects who achieved moderate or lower TR at 30 days; however, there was no difference in mortality among subjects that achieved moderate, mild, or trace TR at 30 days. In addition to TR reduction at 30 days, baseline serum creatinine and baseline RV TAPSE were independently associated with mortality at 1 year (OR: 2.169, 95% CI: [1.494, 3.147], P<0.0001; OR: 0.636, 95% CI: [0.415, 0.974], P=0.0375). Mortality was not associated with baseline TR grade, nor with center volume.
CONCLUSIONS CONCLUSIONS
Tricuspid TEER using the TriClip system was safe and effective through 1 year for subjects with significant TR and advanced disease in a diverse, real-world population.

Identifiants

pubmed: 38759905
pii: S0735-1097(24)07207-3
doi: 10.1016/j.jacc.2024.05.006
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

Copyright © 2024. Published by Elsevier Inc.

Auteurs

Philipp Lurz (P)

Department of Cardiology, University Medical Center Mainz, Mainz, Germany;. Electronic address: Lurzphil@uni-mainz.de.

Karl-Philipp Rommel (KP)

Heart Center Leipzig at University of Leipzig, Leipzig, Germany.

Thomas Schmitz (T)

Elisabeth-Krankenhaus Essen GmbH, Essen, Germany.

Raffi Bekeredjian (R)

Robert-Bosch-Krankenhaus, Stuttgart, Germany.

Georg Nickenig (G)

Heart Center University Hospital Bonn, Bonn, Germany.

Helge Möllmann (H)

St.-Johannes-Hospital, Dortmund, Germany.

Ralph Stephan von Bardeleben (RS)

Department of Cardiology, University Medical Center Mainz, Mainz, Germany.

Alexander Schmeisser (A)

Otto-von-Guericke-Universität Magdeburg, Magdeburg, Germany.

Iskandar Atmowihardjo (I)

DRK Kliniken Berlin Köpenick, Berlin, Germany.

Rodrigo Estevez-Loureiro (R)

Hospital Alvaro Cunqueiro, Dept of Interventional Cardiology, Vigo, Pontevedra, Spain.

Edith Lubos (E)

Katholisches Marienkrankenhaus GmbH, Hamburg, Germany.

Megan Heitkemper (M)

Abbott Structural Heart, California, USA.

Kelli Peterman (K)

Abbott Structural Heart, California, USA.

Harald Lapp (H)

Zentralklinik Bad Berka GmbH, Bad Berka, Germany.

Erwan Donal (E)

CHU Rennes, Rennes France.

Classifications MeSH