Improving quality of life with the TriClip therapy
Tricuspid regurgitation* is caused by a leak in the tricuspid valve and can be detected in around 65 to 85% of the population. What is compensated for by the heart in the mild stage and therefore often goes unnoticed for a long time, has fatal consequences for health as the severity increases.1 The good news: many sufferers can be successfully helped by a minimally invasive procedure with the TriClip™ from Abbott.
It has been called the "forgotten heart valve", is located in the opening between the right atrium and the right ventricle and usually consists of three (Latin "tri") tissue leaflets: the tricuspid valve. If it is fully functional, its leaflets act like a return valve and ensure that blood flows from the right atrium into the right ventricle, but not back.
However, much more often than expected, the heart valve is leaky and the blood flow is disrupted. In medicine, this is known as tricuspid regurgitation. In rare cases, this is congenital, but is usually the result of a pre-existing condition. These include, for example, diseases of the aortic and/or mitral valve such as aortic valve stenosis, mitral valve stenosis or mitral regurgitation, dysfunction of the left ventricle, atrial fibrillation, pulmonary hypertension or inflammation of the inner lining of the heart (endocarditis). In addition, the competence of the valve may be restricted by a pacemaker lead, for example. In order to continue pumping enough blood into the body, the heart then works all the harder and so tricuspid regurgitation (TR) - as well as mild forms of other heart valve diseases - often remains undetected at an early stage. However, if left untreated, tricuspid regurgitation progresses over time. But that's not all: the heart muscle thickens due to the constant extra work. In addition, the pressure in the right heart increases, which causes the right ventricular wall to expand. This causes heart chambers to enlarge and the valve leaflets to be pulled apart. Over time, the heart is no longer able to compensate for the backflow of blood through the defective "valve" and becomes weaker and weaker. Performance and quality of life increasingly decline. The fatal thing is that the first symptoms of this heart disease are often only attributed to the ageing process and not examined by a doctor. As a result, many patients with tricuspid regurgitation are not diagnosed until the disease is already advanced and they are admitted to hospital as a high-risk patient or emergency.2
In the over 65 age group, one in 30 people suffers from moderate to severe tricuspid regurgitation. Women are significantly more frequently affected than men. In many cases, mitral regurgitation is present in addition to tricuspid regurgitation.4,5,6,7
- References
- Sorajja P, Whisenant B, Hamid N et al. Transcatheter Repair for Patients with Tricuspid Regurgitation. N Engl J Med. 2023;388(20):1833-1842.
- German Society of Cardiology - Cardiovascular Research e.V., Tricuspid valve regurgitation, DGK position paper, Cardiology 2022;-16:372-382.
- Initiative Herzklappen e.V., "Heart valve diseases in Germany. Faster to effective treatment", 2023. Available online at: initiative-herzklappe.de/publikationen/
- Gesund.bund.de, Heart valve disease, available online at: gesund.bund.de/herzklappenerkrankung
- Topilsky Y. Tricuspid valve regurgitation: epidemiology and pathophysiology. Minerva Cardioangiol. 2018;66(6):673-679.
- Topilsky Y, Maltais S, Medina Inojosa J et al. Burden of Tricuspid Regurgitation in Patients Diagnosed in the Community Setting. JACC Cardiovasc Imaging. 2019;12(3):433-442.
- Beckmann A, Meyer R, Lewandowski J et al. German Heart Surgery Report 2019: The Annual Updated Registry of the German Society for Thoracic and Cardiovascular Surgery. Thorac Cardiovasc Surg. 2020;68(4):263-76.
- Singh JP, Evans JC, Levy D et al. Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study). Am J Cardiol. 1999;83(6):897-902.
- Nath J, Foster E, Heidenreich PA. Impact of tricuspid regurgitation on long-term survival. J Am Coll Cardiol. 2004;43(3):405-409.
- German Medical Association (BÄK), National Association of Statutory Health Insurance Physicians (KBV), Association of the Scientific Medical Societies in Germany (AWMF). National Disease Management Guideline Chronic Heart Failure - Long version. Version 4.0. 2023 [cited: YYYY-MM-DD]. DOI: 10.6101/AZQ/000510. www.leitlinien.de/herzinsuffizienz.
- Vahanian A et al. 2021 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J. 2022;43(7):561-632.
- German Society of Cardiology e.V. Pocket Guideline Valvular Heart Disease, Version 2021, Börm Bruckmeier Verlag.
- Nickenig G, Weber M, Lurz P, et al. Transcatheter edge-to-edge repair for reduction of tricuspid regurgitation: 6-month outcomes of the TRILUMINATE single-arm study. Lancet. 2019;394(10213):2002-2011.
- von Bardeleben RS, Lurz P, Sorajja P et al. Two-Year Outcomes for Tricuspid Repair With a Transcatheter Edge-to-Edge Valve Repair From the Transatlantic TRILUMINATE Trial. Circ Cardiovasc Interv. 2023;16(8):e012888.
- Arnold SV, Goates S, Sorajja P et al. Health Status After Transcatheter Tricuspid Valve Repair in Patients With Severe Tricuspid Regurgitation. J Am Coll Cardiol. 2024;83(1):1-13.
- Lurz P, Besler C, Schmitz T et al. Short-Term Outcomes of Tricuspid Edge-to-Edge Repair in Clinical Practice. J Am Coll Cardiol. 2023;82(4):281-291.
- Lurz P, von Bardeleben RS, Weber M, et al. Transcatheter Edge-to-Edge Repair for Treatment of Tricuspid Regurgitation. J Am Coll Cardiol. 2021;77(3):229-239.
- German Society of Cardiology - Cardiovascular Research e.V., Tricuspid valve regurgitation, DGK position paper, Cardiology 2022;-16:372-382.
Further links:- Initiative Herzklappen e.V., "Herzklappen-Erkrankungen in Deutschland. Faster to effective treatment", 2023. Available online at: initiative-herzklappe.de/publikationen/
- Gesund.bund.de, Heart valve disease, available online at: gesund.bund.de/herzklappenerkrankung
9-UK-5-16532-01 08-2025