Initial Experience of Orthotopic Tricuspid Valve Replacement in Spain: TRI-SPA Replace Registry.

Background: Transcatheter tricuspid valve replacement (TTVR) is a novel technique for the treatment of symptomatic tricuspid regurgitation (TR).

Aims: This study aims to present the initial experience in Spain and report short-term outcomes of this therapy.

Methods: This was a multicenter, retrospective registry including 48 patients who underwent percutaneous tricuspid valve replacement between April 2022 and September 2024. The primary efficacy objectives were procedural success and the degree of regurgitation at discharge. The primary safety objectives included all-cause mortality, hospitalization for heart failure, and other major adverse cardiovascular events.

Results: A total of 48 patients were included (79 [72-82] years, 75% women, TRISCORE 5 [4-6] points). Sixty-three percent of the patients were in New York Heart Association (NYHA) functional class ≥ III. TR was predominantly of secondary etiology (87%). Procedural success was 98%. The entire treated population achieved TR ≤ 2+ at discharge (100%), and TR ≤ 1+ was achieved in 94% of patients. A permanent pacemaker was implanted in 15.8% of patients. At 30 days, overall mortality was 2.2%, 82% of patients were in NYHA class I/II, and 100% and 94% had TR grades ≤ 2+ and ≤ 1+, respectively.

Conclusions: Percutaneous tricuspid valve replacement proved to be effective and safe, with a high procedural success rate and a low incidence of adverse events. At 30 days, a significant reduction in TR grade was observed, along with an improvement in functional class.