TCT-865 Impact of a Standardized Algorithm on Device Selection in Severe Tricuspid Regurgitation

Document Type

Conference Proceeding

Publication Date

10-28-2025

Publication Title

J Am Coll Cardiol

Abstract

Background: Repair and replacement options are available for patients with severe tricuspid regurgitation (TR). We describe the determinants and impact of a standardized algorithm on device selection in patients evaluated for severe TR. Methods: From October of 2024 to April of 2025, all patients who were presented for management of severe TR at the heart team meeting were evaluated for device selection according to an institution specific standardized algorithm (Figure 1.) Reasons for ultimate device selection when clinical and anatomic equipoise was established were left to the discretion of the operator. [Formula presented] Results: A total of 93 patients were evaluated during this time. The median age was 76 (IQR; 70-83), 57% (53/93) were women, and 75.2% (70/93) were white. 62.3% (58/93) of patients ultimately underwent transcatheter tricuspid valve intervention (TTVI), 0.04% (4/93) underwent surgery, and 33.3% (31/93) did not undergo treatment. 56.9% (33/58) of those who underwent TTVI were determined to be both clinically and anatomically suitable for either therapy. Of those patients who underwent TTVI, 74.1% (43/58) had TTVR and 25.9% (15/58) had TV-TEER. The most common reason to undergo TTVR was for the perceived decrease in residual TR (65%). The most common reason to undergo TV-TEER was due to the inability to tolerate anti-coagulation. Conclusion: When a standardized algorithm is applied for device selection in patients with severe TR, the majority (56.9%) are determined to be eligible for both treatments. Future research is needed to help identify determinants of success and failure for commercially available devices. Categories: STRUCTURAL: Valvular Disease and Intervention: Tricuspid

Volume

86

Issue

17

First Page

B375

Last Page

B376

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