Features and short-term outcomes of real-world transcatheter tricuspid valve repair vs. replacement in Asia-Pacific
Issued Date
2026-03-01
Resource Type
ISSN
2225319X
eISSN
23041021
Scopus ID
2-s2.0-105034754749
Journal Title
Annals of Cardiothoracic Surgery
Volume
15
Issue
2
Rights Holder(s)
SCOPUS
Bibliographic Citation
Annals of Cardiothoracic Surgery Vol.15 No.2 (2026)
Suggested Citation
Tung Chan V.H., Meemook K., Lee C.W., Lai A., Chang C.C., Ngernsritrakul T., Leelasithorn S., Kam K.K.H., Yan B.P., Lee A.P.W., Tang G.H.L., Lam Y.Y., Sung A.S.H., So K.C.Y. Features and short-term outcomes of real-world transcatheter tricuspid valve repair vs. replacement in Asia-Pacific. Annals of Cardiothoracic Surgery Vol.15 No.2 (2026). doi:10.21037/acs-2025-aw-45-tvd Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/116115
Title
Features and short-term outcomes of real-world transcatheter tricuspid valve repair vs. replacement in Asia-Pacific
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Transcatheter therapies for tricuspid regurgitation (TR), including tricuspid transcatheter edge-to-edge repair (T-TEER) and transcatheter tricuspid valve replacement (TTVR), have shown promising safety and efficacy in clinical trials. However, real-world data in the Asia-Pacific (APAC) region remain limited. This descriptive study evaluates the clinical characteristics, procedural details, and 30-day outcomes of T-TEER and TTVR in patients with severe TR in the APAC region. Methods: A retrospective analysis was conducted on 174 patients with severe symptomatic TR treated between 2017 and 2025 at four centers in Hong Kong, Taiwan, and Thailand. Patients underwent T-TEER or TTVR (heterotopic or orthotopic). The primary outcome was TR reduction to ≤ moderate at 30 days. Secondary outcomes included procedural complications, adverse events, reinterventions, and symptom improvement. Results: Of the total cohort, 136 patients underwent T-TEER and 38 underwent TTVR. The TTVR group had more severe TR [median effective regurgitant orifice (ERO) area: 0.85 vs. 0.57 cm<sup>2</sup>, P=0.001], a larger coaptation gap (median: 9.7 vs. 4.7 mm, P<0.001), and more posteroseptal TR origin (P<0.001). Combined mitral valve intervention was more common in the T-TEER group (50/136 vs. 1/38, P<0.001). At 30 days, TR reduction to ≤ moderate was achieved more frequently with TTVR (100.0%) compared with T-TEER (74.0%, P=0.001). Both groups showed significant symptomatic improvement, with 93.7% and 96.2% achieving New York Heart Association (NYHA) class I/II, respectively. TTVR was associated with higher inpatient major adverse events (15.8% vs. 2.2%, P=0.003), longer hospital stays (median: 15 vs. 5 days, P<0.001), and a greater decline in platelet count (−77,500/μL vs. −23,000/μL, P<0.001). Conclusions: In the APAC region, TTVR is primarily reserved for patients with unfavorable anatomy for T-TEER. Both interventions improve TR and symptoms, but TTVR carries higher procedural risks and longer hospitalization. This comparison was exploratory and hypothesis-generating. These findings emphasize regional practice patterns and the need for long-term comparative studies to optimize treatment strategies.