Tricuspid transcatheter edge-to-edge repair (T-TEER) significantly reduced the severity of secondary tricuspid regurgitation (TR) and improved quality of life after one year, based on findings from the Tri.fr trial presented at ESC Congress 2024 in London.

Researchers randomized 300 patients from 24 centers in France and Belgium to receive either T-TEER in addition to optimal medical treatment or to optimal medical treatment alone. All patients had symptomatic, severe secondary TR despite medical management, were stable for at least 30 days and were ineligible for surgery. Additionally, the mean age of participants was 78 years, 54% were women, 15% had a cardiac implantable electronic device and 40% had been hospitalized for heart failure within one year before enrollment.

Overall results found that Packer composite score rate improvements – the primary endpoint – were higher among those receiving T-TEER compared with those receiving medical therapy alone (74.1% vs. 46%, respectively). The Packer composite score combines New York Heart Association class, patient global assessment and major cardiovascular events. Study investigators also noted that the severity of TR significantly improved in the T-TEER cohort compared with the medical therapy cohort. Lower rates of hospitalization and death and improvements in quality of life were also observed in the T-TEER group.

"A key message of the Tri.fr trial is that implementing rigorous multidisciplinary medical management resulted in a low event rate, even in very ill patients with secondary TR. Using T-TEER with optimal medical management also led to important quality-of-life improvements," said Principal Investigator Erwan Donal, MD. "It remains to be seen if patients with a particular phenotype of severe TR derive more benefit from T-TEER than others. We expect to provide more insightful outcomes data in the coming years as we continue to follow-up the trial participants."