Initial Real-World Experience of Tricuspid Transcatheter Edge-to-Edge Repair in Asia (JACC Asia January 2026)-Article: Initial Real-World Experience of Tricuspid Transcatheter Edge-to-Edge Repair in Asia

Article: Initial Real-World Experience of Tricuspid Transcatheter Edge-to-Edge Repair in Asia

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This multicenter registry reports the first substantial real‑world experience with tricuspid transcatheter edge‑to‑edge repair (T‑TEER) in Asia, where access to dedicated devices and operator experience have been limited. Four major Asian centers enrolled all consecutive patients treated for severe symptomatic tricuspid regurgitation (TR) from 2017–2024 (N=106; mean age 76 years; 55% female). The cohort was high risk with prevalent atrial fibrillation (89%), frequent prior cardiac surgery (26%), and cardiac implantable electronic devices (18%). TR was predominantly functional (89%), and more than half of patients had massive or torrential TR (57%); TR was diffuse across valve segments in 57%. Moderate-or-worse mitral regurgitation coexisted in about half.<br /><br />Early cases used off‑label MitraClip (23%), later transitioning mainly to the dedicated TriClip system (77%). Procedures typically used a median of 2 clips, most often placed anteroseptally, with single‑clip, “zipping,” and “clover” strategies used at similar rates. Combined transcatheter procedures were common (47%), including concomitant mitral TEER and other structural interventions.<br /><br />At 30 days (104 patients with follow-up), device success—defined as residual TR ≤ moderate—was achieved in 74%. TR improved by at least one grade in 95% and by at least two grades in 69%. Symptoms improved markedly: NYHA class I/II increased to 96% (from 51% at baseline). Safety outcomes were favorable, with no inpatient death, myocardial infarction, or stroke; single‑leaflet device attachment occurred in 4.7%, and 30‑day major adverse events were 1.9% (new renal failure only).<br /><br />Predictors of 30‑day success included less severe baseline TR (non‑torrential) and greater site experience (second half of cases), supporting a learning‑curve effect. Outcomes with TriClip were comparable to major Western registries, suggesting T‑TEER is feasible, effective, and safe in early Asian practice.

Keywords

tricuspid transcatheter edge-to-edge repair

T-TEER

tricuspid regurgitation

Asia multicenter registry

TriClip

MitraClip off-label

functional tricuspid regurgitation

device success residual TR moderate

NYHA functional class improvement

learning curve operator experience