TCT-1195 Outcomes of Transcatheter Tricuspid Valve Replacement in Patients with Multivalvular Disease: Insights from the TRISCEND II Trial
Recommended Citation
Narang A, Hahn R, Davidson C, Grayburn P, Windecker S, Snyder C, Shah J, Puthumana J, Makkar R, Sannino A, Arnold S, Kodali S, Thourani V, Lurz P, Makar M, Sharma R, Haeffele C, O'Neill B, Lee JC, Yadav P, Zahr F, Chadderdon S, Eleid M, Pislaru S, Szerlip M, Whisenant B, Sekaran N, Garcia S, Stewart-Dehner T, Schonning M. TCT-1195 Outcomes of Transcatheter Tricuspid Valve Replacement in Patients with Multivalvular Disease: Insights from the TRISCEND II Trial. J Am Coll Cardiol 2025; 86(17):B511.
Document Type
Conference Proceeding
Publication Date
10-28-2025
Publication Title
J Am Coll Cardiol
Abstract
Background: The TRISCEND II trial demonstrated safety and effectiveness of EVOQUE transcatheter tricuspid valve replacement (TTVR) in patients with ≥ severe tricuspid regurgitation (TR). The impact and evolution of multivalvular disease (MVD) on outcomes following TR elimination with TTVR is unknown. Methods: Within the TRISCEND II trial, we compared patients with and without MVD (defined as concomitant ≥ mild MVD at baseline). Severe concomitant VHD were excluded in the trial. Change in KCCQ-OS from baseline to 1 year was modeled using ANCOVA, adjusted for baseline KCCQ-OS and tested the interaction of MVD*TTVR, to determine whether MVD modified the previously confirmed health status benefit of TTVR. Results: Among 382 patients randomized to TTVR or optimal medical therapy (OMT), 291 (76.2%) had MVD. Patients with MVD were slightly older, but other demographics and comorbidities were similar between groups. Mean baseline KCCQ-OS was significantly lower in MVD cohort (50.7 ± 21.6 vs. 57.5 ± 21.2, p = 0.008). TR etiology was secondary in 73.3%, primary in 12.6%, and cardiac implantable electronic device-related in 2.1%, with no difference in etiology or severity between groups. Overall, 31.4% had prior left-sided valve surgery/intervention. Severity of each valve disease at baseline assessed by the echocardiography core lab is shown (Table). MVD improved or stayed the same in the majority of patients, regardless of treatment arm (Figure A). No significant interaction was observed between MVD status and TTVR compared with OMT on improvement in 1-year KCCQ-OS score (pinteraction = 0.44) (Figure B). Conclusions: In the TRISCEND II trial, most patients demonstrated improvement or stability of MVD. Preexisting MVD did not modify the significant QOL benefit of TTVR compared to medical therapy alone. Further detailed analysis of clinical, echocardiographic, and health status outcomes will be available at the time of presentation. [Formula presented] [Formula presented]
Volume
86
Issue
17
First Page
B511
