Clinical outcomes of tricuspid transcatheter edge-to-edge repair in patients with tricuspid regurgitation.

Objective: To evaluate the association between tricuspid transcatheter edge-to-edge repair (T-TEER) and long-term clinical outcomes in patients with tricuspid regurgitation (TR) compared with medical therapy alone. Methods: We conducted a retrospective cohort study using the TriNetX global federated health research network. Adults with TR between 2015 and 2025 were identified and categorized into T-TEER and non-procedure groups. Propensity score matching was performed to balance baseline characteristics. The primary outcome was all-cause mortality. Secondary outcomes included heart failure exacerbation, emergency department visits, hospitalization, and major adverse kidney events (MAKEs). Cox proportional hazards models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). Results: After matching, 483 patients were included in each group. T-TEER was associated with a significantly lower risk of all-cause mortality at 1 year (HR 0.59, 95% CI 0.41-0.86), with sustained benefit at 3 years (HR 0.65, 95% CI 0.48-0.88) and 5 years (HR 0.68, 95% CI 0.52-0.91). T-TEER was also associated with reduced risks of heart failure exacerbation (HR 0.51), hospitalization (HR 0.60), emergency visits (HR 0.63), and MAKEs (HR 0.60) at 1 year. These associations remained consistent across longer follow-up. Conclusion: In this large real-world cohort, T-TEER was associated with lower risks of mortality and adverse clinical outcomes compared with medical therapy alone. These findings support the potential prognostic benefit of T-TEER in patients with TR.