ValveTrials.org

ValveTrials.org · Tricuspid

Tricuspid Valve Trials

Major transcatheter (and key comparator) tricuspid-valve trials, grouped into collapsible categories and ordered oldest to newest. Click any trial to read the full entry and open the paper.

17 trials · 14 published · 2 ongoing · 51 linked analyses · 0 negative-result trials excluded · antiplatelet/anticoagulant trials excluded by design

🟢 Published🔵 Ongoing Sorted oldest → newest within each category⚠ Caveat inside
17 / 17 trials shown
Tricuspid TEER9
MitraClip in TR (early) ⚠ Transcatheter Treatment of Severe Tricuspid Regurgitation With the Edge-to-Edge MitraClip Technique The proof-of-concept that launched tricuspid TEER, using the mitral clip off-label. 🟢 Published3 follow-upsEnrolled 2015–2016Published 2017
Nickenig G, Kowalski M, Hausleiter J, et al. · Circulation · 2017
⚠ Off-label early experience with the mitral device, before dedicated tricuspid systems.

The foundational multicenter experience showing that edge-to-edge repair with the MitraClip could be applied to the tricuspid valve, reducing TR and improving symptoms and opening the T-TEER field.

Study overview

DeviceAbbott MitraClip (off-label)
InterventionTEER
ComparatorNone (observational)
PopulationSevere symptomatic TR, high surgical risk
Risk groupHigh surgical risk
Sample size64
Enrollment2015–2016
Follow-up30 days
Trial typeMulticenter observational

Inclusion criteria

—

Primary endpoint

Feasibility, procedural success, and TR reduction.

Secondary endpoints

—

Key results

  • Procedural success with significant acute TR reduction
  • Symptomatic improvement; established feasibility of the edge-to-edge concept in the tricuspid position

Why this trial matters

Opened the dedicated T-TEER field (TRILUMINATE, CLASP TR) that followed.

Clinical pearls

  • Repurposing the mitral clip proved the anatomy was tractable before dedicated devices existed.

Limitations

  • Off-label device
  • Observational, no comparator
  • Early-generation hardware

Serial follow-ups & subanalyses 3

Click a follow-up to reveal its paper links.

Impact of baseline tricuspid regurgitation
Schueler R, et al. Clinical research in cardiology : official journal of the German Cardiac Society 2017;106(5):350-358.
Predictors of outcome
Besler C, et al. JACC Cardiovasc Interv 2018;11(12):1119-1128.
HF hospitalization reduction
Orban M, et al. JACC Heart Fail 2020;8(4):265-276.
TRILUMINATE Trial to Evaluate Treatment With Abbott Transcatheter Clip Repair System in Patients With Moderate or Greater TR (Single-Arm) Proved tricuspid TEER was feasible and safe, launching the modern T-TEER era. 🟢 Published3 follow-upsEnrolled 2017–2018Published 2019
Nickenig G, et al. · The Lancet · 2019

The single-arm feasibility study that established transcatheter edge-to-edge repair of the tricuspid valve as feasible and safe, reducing TR and improving symptoms — the basis for CE mark.

Study overview

DeviceAbbott TriClip
InterventionTEER
ComparatorNone (single-arm)
PopulationModerate or greater symptomatic TR, high surgical risk
Risk groupHigh surgical risk
Sample size85
Enrollment2017–2018
Follow-up30 days, 1 year, 3 years
Trial typeProspective single-arm, multicenter

Inclusion criteria

—

Primary endpoint

Safety and reduction in TR severity.

Secondary endpoints

  • NYHA class
  • 6-minute walk
  • Quality of life
  • Right-heart remodeling

Key results

  • Significant TR reduction with a strong safety profile
  • Durable symptom and functional improvement through 3 years

Why this trial matters

First convincing tricuspid TEER dataset; led to CE mark (2020).

Clinical pearls

  • Used the first-generation clip in a highly selected population.

Limitations

  • Single-arm
  • Selected anatomy
  • First-generation device

Serial follow-ups & subanalyses 3

Click a follow-up to reveal its paper links.

1-year
Lurz P, et al. J Am Coll Cardiol 2021;77(3):229-239.
2-year
von Bardeleben RS, et al. Circ Cardiovasc Interv 2023;16(8):e012888.
3-year
Nickenig G, et al. JACC Cardiovasc Interv 2024;17(18):2113-2122.
TriValve Registry ⚠ International Multisite Transcatheter Tricuspid Valve Therapies (TriValve) Registry The registry that first suggested a survival signal for transcatheter TR therapy — later tempered by randomized data. 🟢 Published11 follow-upsEnrolled 2016–2018Published 2019
Taramasso M, Benfari G, van der Bijl P, et al. · Journal of the American College of Cardiology · 2019
⚠ Multi-device registry (TEER plus other devices); propensity-matched, not randomized.

The landmark international registry of transcatheter tricuspid therapies; its propensity-matched comparison suggested a survival and heart-failure benefit of intervention over medical therapy, and its edge-to-edge subset defined early real-world TEER outcomes.

Study overview

DeviceMultiple (MitraClip/PASCAL TEER, Cardioband, others)
InterventionTranscatheter tricuspid intervention
ComparatorMedical therapy (propensity-matched)
PopulationSevere symptomatic TR
Risk groupHigh surgical risk
Sample size472 vs 1,179 (matched)
Enrollment2016–2018
Follow-up1–2 years
Trial typeInternational registry / propensity-matched

Inclusion criteria

—

Primary endpoint

Survival and heart-failure rehospitalization vs medical therapy.

Secondary endpoints

—

Key results

  • Transcatheter intervention associated with improved survival and fewer HF hospitalizations vs matched medical therapy
  • Edge-to-edge subset: 1-year TR ≤2+ in ~72%, NYHA ≤II in ~69%

Why this trial matters

Framed the rationale for randomized T-TEER trials; benefit later only partly confirmed by TRILUMINATE Pivotal.

Clinical pearls

  • Registry survival signal exceeded what the randomized trials later showed — selection bias matters.

Limitations

  • Non-randomized
  • Propensity-matched
  • Device-heterogeneous

Serial follow-ups & subanalyses 11

Click a follow-up to reveal its paper links.

Which patients are treated
Taramasso M, et al. JACC Cardiovasc Interv 2017;10(19):1982-1990.
1-year edge-to-edge (TEER)
Mehr M, et al. JACC Cardiovasc Interv 2019;12(15):1451-1461.
Mid-term (all devices)
Taramasso M, et al. JACC Cardiovasc Interv 2019;12(2):155-165.
Conduction/pacemaker
Taramasso M, et al. JACC. Cardiovascular interventions 2020;13(5):554-564.
Impact of Massive or Torrential
Miura M, et al. JACC. Cardiovascular interventions 2020;13(17):1999-2009.
Transcatheter Tricuspid Valve Intervention in
Muntané-Carol G, et al. Circulation. Cardiovascular interventions 2021;14(2):e009685.
Right VentricularPulmonary Arterial Coupling and
Brener MI, et al. Journal of the American College of Cardiology 2022;79(5):448-461.
Mitral regurgitation evolution after transcatheter
Cannata F, et al. European heart journal. Cardiovascular Imaging 2024;26(1):135-147.
Effects of tricuspid transcatheter edgetoedge
Russo G, et al. International journal of cardiology 2024;405:131934.
TRIVALVE Score A Risk Score
Russo G, et al. JACC. Cardiovascular interventions 2024;17(18):2170-2179.
Incidence Predictors and Outcomes of
Dykun I, et al. JACC. Cardiovascular interventions 2026;19(6):711-722.
TRILUMINATE Pivotal TRILUMINATE Pivotal Trial of Tricuspid TEER vs Medical Therapy Established tricuspid TEER as an FDA-approved therapy; benefit is real but largely symptomatic/QoL. 🟢 Published7 follow-upsEnrolled 2019–2021Published 2023
Sorajja P, Whisenant B, Hamid N, et al. · New England Journal of Medicine · 2023

The first randomized tricuspid TEER trial: TriClip beat medical therapy on a hierarchical composite driven mainly by quality-of-life improvement, with excellent safety and durable TR reduction — the basis for FDA approval.

Study overview

DeviceAbbott TriClip
InterventionTEER
ComparatorGuideline-directed medical therapy
PopulationSevere symptomatic TR, intermediate-or-greater surgical risk
Risk groupIntermediate+ surgical risk
Sample size350 (175 / 175) + single-arm
Enrollment2019–2021
Follow-up1 and 2 years
Trial typeRandomized, open-label

Inclusion criteria

—

Primary endpoint

Hierarchical composite (win ratio) of death/tricuspid surgery, HF hospitalization, and KCCQ change at 1 year.

Secondary endpoints

  • TR grade ≤moderate
  • KCCQ
  • NYHA / 6-minute walk
  • Safety (MAE)

Key results

  • Win ratio 1.48 (95% CI 1.06–2.13, P=0.02), driven by quality of life
  • TR reduced to moderate-or-less in ~90% at 30 days, sustained at 1 year
  • >98% free from major adverse events at 30 days
  • No significant reduction in death or HF hospitalization

Why this trial matters

Practice-changing: basis for FDA approval of TriClip (April 2024).

Clinical pearls

  • Benefit is predominantly symptomatic/QoL — counsel expectations accordingly.
  • TR reduction is durable and the procedure is remarkably safe.

Limitations

  • Open-label
  • Composite driven by KCCQ, not hard outcomes

Serial follow-ups & subanalyses 7

Click a follow-up to reveal its paper links.

Quality of life (KCCQ)
Arnold SV, et al. J Am Coll Cardiol 2024;83(1):1-13.
Renal & liver function
Jorde UP, et al. J Am Coll Cardiol 2024;84(25):2446-2456.
Transcatheter EdgetoEdge Repair inPatients With
Adams DH, et al. JACC. Cardiovascular interventions 2024;17(23):2749-2760.
1-year (randomized cohort)
Tang GHL, et al. J Am Coll Cardiol 2025;85(3):235-246.
2-year
Kar S, et al. Circulation 2025;151(23):1630-1638.
Imaging / cardiac remodeling substudy
Cavalcante JL, et al. J Am Coll Cardiol 2025;85(3):250-261.
Transvalvular CIED leads
Naik H, et al. JACC Clin Electrophysiol 2025;11(5):1012-1020.
CLASP TR EFS Edwards PASCAL Tricuspid Repair System Early Feasibility Study PASCAL is the second viable tricuspid TEER platform. 🟢 Published1 follow-upEnrolled 2019–2021Published 2023
Kodali SK, Hahn RT, Davidson CJ, et al. · Journal of the American College of Cardiology · 2023

Early feasibility of the PASCAL system for tricuspid TEER, showing durable TR reduction and functional improvement — the PASCAL counterpart to the TriClip program.

Study overview

DeviceEdwards PASCAL / PASCAL Ace
InterventionTEER
ComparatorNone (single-arm)
PopulationSevere symptomatic TR, high surgical risk
Risk groupHigh surgical risk
Sample sizeearly feasibility cohort
Enrollment2019–2021
Follow-up30 days, 1 year, 2 years
Trial typeProspective single-arm (EFS)

Inclusion criteria

—

Primary endpoint

Safety and performance / TR reduction.

Secondary endpoints

  • TR grade
  • NYHA / 6-minute walk
  • KCCQ

Key results

  • Durable TR reduction and functional improvement with good safety

Why this trial matters

Feasibility basis for the PASCAL tricuspid pivotal (CLASP II TR).

Clinical pearls

  • Independent leaflet grasping and a central spacer suit large tricuspid gaps.

Limitations

  • Single-arm
  • Small cohort

Serial follow-ups & subanalyses 1

Click a follow-up to reveal its paper links.

30-day
Kodali S, et al. J Am Coll Cardiol 2021;77(4):345-356.
bRIGHT ⚠ Real-World Outcomes of Tricuspid TEER With TriClip (bRIGHT Study) Real-world data confirm the safety and TR-reduction seen in the randomized trials. 🟢 Published5 follow-upsEnrolled 2020–2023Published 2024
Lurz P, Rommel KP, Schmitz T, et al. · Journal of the American College of Cardiology · 2024
⚠ Post-market registry (not a dedicated NCT here).

A European post-market registry showing that tricuspid TEER reduces TR safely and durably across a broad range of real-world anatomies and centers.

Study overview

DeviceAbbott TriClip / TriClip G4
InterventionTEER
ComparatorRegistry
PopulationSevere symptomatic TR in routine practice
Risk groupMixed / high risk
Sample sizeregistry cohort
Enrollment2020–2023
Follow-up30 days, 1 year, 2 years
Trial typeProspective post-market registry

Inclusion criteria

—

Primary endpoint

Real-world safety and TR reduction.

Secondary endpoints

  • NYHA / KCCQ
  • Durability
  • Procedural success

Key results

  • Significant, durable TR reduction across broad anatomies
  • Safety consistent with the randomized trials

Why this trial matters

Provides generalizability for the RCT findings.

Clinical pearls

  • Broader/less-selected patients and centers than TRILUMINATE.

Limitations

  • Non-randomized registry
  • Shorter-term outcomes

Serial follow-ups & subanalyses 5

Click a follow-up to reveal its paper links.

30-day
Lurz P, et al. J Am Coll Cardiol 2023;82(4):281-291.
Characterization of Tricuspid Valve Anatomy
Donal E, et al. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography 2024;37(4):397-404.
Outcomes of tricuspid transcatheter edgetoedge
Goebel B, et al. EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology 2025;21(5):e253-e261.
Bivalirudin Versus Heparin in Low
Qiu M, et al. Journal of the American College of Cardiology 2026.
Cognitive Behavior vs Bright Light
Do TT, et al. JAMA network open 2026;9(8):e2630320.
TRI-FR Multicentric Randomized Evaluation of Tricuspid TEER in Severe Secondary TR (Tri.Fr) Independent randomized confirmation that tricuspid TEER improves symptoms and functional status. 🟢 Published2 follow-upsEnrolled 2021–2023Published 2025
Donal E, Dreyfus J, Leurent G, et al. · JAMA · 2025

A French/Belgian investigator-led RCT: tricuspid TEER plus medical therapy improved a clinical composite (symptoms, TR, functional status) versus medical therapy alone — the second positive randomized T-TEER trial.

Study overview

DeviceAbbott TriClip G4
InterventionTEER + GDMT
ComparatorGDMT alone
PopulationSevere isolated secondary TR, ineligible for surgery
Risk groupHigh surgical risk
Sample size300
Enrollment2021–2023
Follow-up1 year
Trial typeRandomized, open-label

Inclusion criteria

—

Primary endpoint

Packer clinical composite score (improved / unchanged / worse) at 1 year.

Secondary endpoints

  • Patient global assessment
  • TR grade
  • 6-minute walk
  • KCCQ

Key results

  • Composite improvement 74.6% (TEER) vs 39.5% (GDMT); effect estimate 0.68 (P<0.0001)
  • Technical success 97.3%; in-hospital mortality 0.6%
  • Most patients required 2 devices

Why this trial matters

Sponsor-independent confirmation of TRILUMINATE Pivotal's QoL/functional benefit.

Clinical pearls

  • Government-funded trial — reduces industry-sponsorship concerns.
  • Reinforces that the benefit is symptomatic/functional.

Limitations

  • Open-label
  • Composite is symptom/QoL-weighted

Serial follow-ups & subanalyses 2

Click a follow-up to reveal its paper links.

Multicentric randomized evaluation of a
Donal E, et al. European heart journal. Cardiovascular Imaging 2022;23(12):1617-1627.
Echocardiographic outcomes
Donal E, et al. JACC Cardiovasc Imaging 2025.
EuroTR Registry European Real-World Registry of Transcatheter Leaflet Repair for Tricuspid Regurgitation (EuroTR) The biggest real-world European T-TEER dataset — generalizes the trial findings across both devices. 🟢 Published4 follow-upsEnrolled 2016–2023Published 2025
Wild MG, Stolz L, Rosch S, et al. · Journal of the American College of Cardiology · 2025

A large European real-world registry of tricuspid leaflet-repair (TEER) with both MitraClip and PASCAL, confirming durable TR reduction and symptom benefit across routine practice, and identifying residual TR as a key prognostic marker.

Study overview

DeviceMitraClip and PASCAL
InterventionTEER (leaflet repair)
ComparatorRegistry
PopulationSevere symptomatic TR in routine practice
Risk groupMixed / high risk
Sample sizelarge multicenter cohort
Enrollment2016–2023
Follow-up30 days, 1 year
Trial typeProspective multicenter registry

Inclusion criteria

—

Primary endpoint

Real-world procedural success, TR reduction, and 1-year outcomes.

Secondary endpoints

—

Key results

  • Durable TR reduction and symptom improvement across both devices
  • Residual TR severity independently associated with 1-year outcome

Why this trial matters

Cross-device generalizability for T-TEER outside the pivotal trials.

Clinical pearls

  • Includes both leaflet-repair platforms, unlike the device-specific pivotal trials.

Limitations

  • Non-randomized registry
  • Device-heterogeneous

Serial follow-ups & subanalyses 4

Click a follow-up to reveal its paper links.

30-day / early experience
Wild MG, et al. JACC Cardiovasc Interv 2022;15(13):1352-1363.
Residual tricuspid regurgitation after tricuspid
Stolz L, et al. European journal of heart failure 2024;26(8):1850-1860.
Invasive Hemodynamics and Risk Stratification
Masiero G, et al. Circulation. Cardiovascular interventions 2026;19(1):e015964.
Prognostic Value of NTproBNP in
von Stein J, et al. JACC. Cardiovascular interventions 2026;19(10):1225-1239.
CLASP II TR Edwards PASCAL Tricuspid Repair System Pivotal Trial The key pivotal that could bring PASCAL to FDA approval for tricuspid TEER. 🔵 OngoingEnrolled ongoingNot yet published

The pivotal randomized trial of PASCAL tricuspid TEER plus medical therapy versus medical therapy — the trial that would confirm a second TEER platform for approval.

Study overview

DeviceEdwards PASCAL
InterventionTEER + GDMT
ComparatorGDMT alone
PopulationSevere symptomatic TR
Risk groupHigh surgical risk
Sample sizepivotal target
Enrollmentongoing
Follow-up1 year+
Trial typeRandomized

Inclusion criteria

—

Primary endpoint

Safety/effectiveness vs medical therapy.

Secondary endpoints

—

Key results

  • Pending — trial ongoing

Why this trial matters

Would establish PASCAL as an approved T-TEER option.

Clinical pearls

  • Watch how PASCAL vs TriClip outcomes compare in tricuspid anatomy.

Limitations

  • Not yet reporting
  • NCT unconfirmed here
Tricuspid Transcatheter Replacement (TTVR)3
TRISCEND II Edwards EVOQUE Tricuspid Valve Replacement Pivotal Trial EVOQUE is the first FDA-approved tricuspid replacement, with the strongest win ratio in the field. 🟢 Published7 follow-upsEnrolled 2021–2023Published 2025
Hahn RT, Makkar R, Thourani VH, et al. · New England Journal of Medicine · 2025

The first randomized TTVR trial: EVOQUE plus medical therapy was superior to medical therapy on a hierarchical composite (win ratio ~2.0), with near-complete TR elimination — basis for the first FDA-approved tricuspid replacement.

Study overview

DeviceEdwards EVOQUE
InterventionTTVR + GDMT
ComparatorOptimal medical therapy
PopulationSevere or torrential TR, symptomatic
Risk groupHigh surgical risk
Sample size400 (392 randomized)
Enrollment2021–2023
Follow-up6 months primary; 1 year
Trial typeRandomized, open-label

Inclusion criteria

—

Primary endpoint

Hierarchical composite (win ratio) of death, RVAD/transplant, tricuspid intervention, HF hospitalization, KCCQ, NYHA, and 6-minute walk at 1 year.

Secondary endpoints

  • TR grade ≤mild
  • KCCQ
  • NYHA / 6-minute walk
  • Safety (MAE)

Key results

  • Win ratio 2.02 (95% CI 1.56–2.62, P<0.001) favoring EVOQUE
  • ~95–99% achieved TR ≤mild
  • More new pacemakers and bleeding with EVOQUE

Why this trial matters

Basis for the first FDA-approved transcatheter tricuspid replacement (Feb 2024).

Clinical pearls

  • Largest treatment effect in tricuspid trials — but weigh pacemaker/anticoagulation trade-offs.
  • Approved without an FDA advisory panel, on a prespecified 6-month analysis of the first 150 patients.

Limitations

  • Open-label
  • Pacemaker and bleeding risk
  • Composite includes softer endpoints

Serial follow-ups & subanalyses 7

Click a follow-up to reveal its paper links.

TRISCEND EFS
Kodali S, Hahn RT, George I. JACC Cardiovasc Interv. 2022;15(5):471-480.
TRISCEND II Novel Randomized Trial
Grayburn PA, et al. The American journal of cardiology 2024;225:171-177.
Quality of life (1-year)
Arnold SV, et al. J Am Coll Cardiol 2025;85(3):206-216.
Outcomes by baseline TR severity
Lurz P, Hahn RT, Kodali S, et al. Eur Heart J 2025.
Echocardiographic outcomes
Sannino A, et al. JACC. Cardiovascular imaging 2026.
Cost-effectiveness
Grangeon A, et al. ESC heart failure 2026.
Clinical Characteristics and Outcomes of
Razmjou S, et al. Journal of the Society for Cardiovascular Angiography & Interventions 2026;5(4):104385.
LuX-Valve LuX-Valve / LuX-Valve Plus Transcatheter Tricuspid Replacement Program A distinct TTVR design worth tracking as it moves toward transfemoral delivery and wider study. • Published2 follow-upsEnrolled 2020-2021Published 2025
Pan X, et al. · JACC. Cardiovascular interventions · 2025

A non-radial-force tricuspid replacement anchored to the interventricular septum; early (mainly Chinese) experience shows high TR elimination, with transfemoral (LuX-Valve Plus) iterations advancing.

Study overview

DeviceJenscare LuX-Valve / LuX-Valve Plus
InterventionTranscatheter tricuspid replacement
ComparatorNone (single-arm)
PopulationSevere symptomatic TR, high surgical risk
Risk groupHigh surgical risk
Sample sizenot fully extracted
Enrollment2020-2021
Follow-upongoing
Trial typeSingle-arm / early studies

Inclusion criteria

—

Primary endpoint

Safety and TR reduction.

Secondary endpoints

—

Key results

  • High TR elimination in early series; broader/Western data still limited

Why this trial matters

Septal-anchoring design avoids radial force on the annulus.

Clinical pearls

  • LuX-Valve Plus moves to transjugular/transfemoral delivery.

Limitations

  • Limited Western data

Serial follow-ups & subanalyses 2

Click a follow-up to reveal its paper links.

Echocardiographic outcomes
Huang L, et al. Frontiers in cardiovascular medicine 2024;11:1417757.
1-year
Stolz L, et al. European journal of heart failure 2025;27(11):2644-2648.
TVT Registry — TTVR ⚠ Real-World Outcomes of Transcatheter Tricuspid Valve Replacement: Analysis From the STS/ACC TVT Registry Real-world confirmation that TTVR translates from trial to routine US practice — with lower-than-trial pacemaker and bleeding rates. 🟢 PublishedEnrolled Feb 2024–Mar 2025Published 2026
Makkar RR, Gupta A, O'Neill BP, et al. · JAMA · 2026
⚠ Post-approval real-world registry (30-day outcomes); retrospective, no comparator.

The first US real-world report of commercial EVOQUE tricuspid replacement — 1,034 consecutive patients in the first year after FDA approval — showing near-complete TR elimination and rapid health-status improvement, with 30-day outcomes consistent with (and pacemaker/bleeding rates lower than) the TRISCEND II trial.

Study overview

DeviceEdwards EVOQUE
InterventionTranscatheter tricuspid replacement (commercial)
ComparatorNone (registry)
PopulationSevere symptomatic TR undergoing commercial TTVR
Risk groupOlder, medically complex (mean age 77; 69% female)
Sample size1,034 (82 US centers)
EnrollmentFeb 2024–Mar 2025
Follow-up30 days
Trial typeRetrospective real-world registry

Inclusion criteria

—

Primary endpoint

30-day clinical, echocardiographic, and health-status (KCCQ) outcomes.

Secondary endpoints

  • TR reduction to ≤mild
  • New pacemaker implantation
  • Bleeding
  • Procedural success

Key results

  • High procedural success with near-complete TR elimination
  • Rapid, significant KCCQ health-status improvement at 30 days
  • New-pacemaker and bleeding rates lower than in the randomized trials
  • 30-day outcomes consistent with TRISCEND II

Why this trial matters

First large-scale real-world validation of EVOQUE after US approval; supports generalizability of the pivotal-trial findings.

Clinical pearls

  • Real-world pacemaker/bleeding rates ran below the trial — reassuring as adoption widens.
  • Only 30-day data so far; durability and 1-year outcomes are the next question.

Limitations

  • Retrospective, no comparator
  • 30-day follow-up only
  • Early adopter centers
Tricuspid Annuloplasty2
SCOUT ⚠ Percutaneous Tricuspid Valve Annuloplasty System for Symptomatic Chronic Functional TR (Trialign) An early proof-of-concept for suture-based tricuspid annuloplasty. 🟢 PublishedEnrolled 2015–2016Published 2017
Hahn RT, Meduri CU, Davidson CJ, et al. · Journal of the American College of Cardiology · 2017
⚠ Early device; limited ongoing clinical development.

An early feasibility study of the Trialign system, which plicates the annulus to mimic a surgical Kay bicuspidization, showing reduced annular area and TR.

Study overview

DeviceMitralign Trialign
InterventionDirect annuloplasty (bicuspidization)
ComparatorNone (single-arm)
PopulationSymptomatic chronic functional TR
Risk groupHigh surgical risk
Sample size15 (SCOUT I)
Enrollment2015–2016
Follow-up30 days, 6 months
Trial typeProspective single-arm (early feasibility)

Inclusion criteria

—

Primary endpoint

Feasibility, safety, and annular/TR reduction.

Secondary endpoints

  • Annular area
  • TR grade
  • 6-minute walk
  • Quality of life

Key results

  • Reduced annular area and TR with functional improvement
  • Single-leaflet dehiscence observed in some patients

Why this trial matters

One of the first transcatheter tricuspid annuloplasty concepts.

Clinical pearls

  • Recreates a surgical Kay-type annuloplasty percutaneously.

Limitations

  • Very small
  • Durability/dehiscence concerns
  • Limited ongoing development
TRI-REPAIR TrIcuspid Regurgitation RePAIr With Cardioband Device Study Direct annuloplasty can remodel the tricuspid annulus, but the evidence base is smaller than TEER. 🟢 Published4 follow-upsEnrolled 2016–2017Published 2019
Nickenig G, Weber M, Schueler R, et al. · Journal of the American College of Cardiology · 2019

Direct transcatheter annuloplasty of the tricuspid annulus with Cardioband reduced annular size and TR with durable symptom improvement — a repair-based alternative to TEER and replacement.

Study overview

DeviceEdwards Cardioband (tricuspid)
InterventionDirect annuloplasty
ComparatorNone (single-arm)
PopulationSymptomatic functional TR, high surgical risk
Risk groupHigh surgical risk
Sample size30
Enrollment2016–2017
Follow-up6 months, 1 year, 2 years
Trial typeProspective single-arm, multicenter

Inclusion criteria

—

Primary endpoint

Safety and annular/TR reduction.

Secondary endpoints

  • Septolateral annular diameter
  • TR grade
  • NYHA / 6-minute walk
  • KCCQ

Key results

  • Significant annular reduction and TR improvement
  • Durable functional gains through 2 years

Why this trial matters

CE-mark tricuspid annuloplasty option; leaflet- and anatomy-preserving.

Clinical pearls

  • Preserves future TEER/replacement options.
  • Right coronary artery course is a key procedural consideration.

Limitations

  • Small single-arm
  • Technically demanding

Serial follow-ups & subanalyses 4

Click a follow-up to reveal its paper links.

Cardioband TR EFS (US) — 30-day
Davidson CJ, et al. JACC Cardiovasc Interv 2021;14(1):41-50.
TriBAND (post-market) — 30-day
Nickenig G, et al. EuroIntervention 2021;17(10):809-817.
2-year
Nickenig G, et al. EuroIntervention 2021;16(15):e1264-e1271.
Cardioband TR EFS (US) — 1-year
JACC Cardiovasc Interv 2022;15(14).
Tricuspid Heterotopic / Caval2
HOVER ⚠ Heterotopic Implantation of the SAPIEN Valve in the Inferior Vena Cava for Severe TR Proof-of-concept that an off-the-shelf valve in the IVC can palliate TR-related congestion. 🟢 Published1 follow-upEnrolled 2015–2019
⚠ Off-label use of a commercially available valve; very small feasibility study.

A feasibility study implanting a balloon-expandable SAPIEN valve in the inferior vena cava to palliate right-heart congestion from severe TR in inoperable patients.

Study overview

DeviceEdwards SAPIEN (in IVC)
InterventionSingle-site caval valve implantation
ComparatorNone (single-arm)
PopulationSevere TR, inoperable / very high risk
Risk groupProhibitive surgical risk
Sample size15 (planned)
Enrollment2015–2019
Follow-up30 days, 6 months
Trial typeProspective single-arm feasibility

Inclusion criteria

—

Primary endpoint

30-day safety; 6-month symptom palliation.

Secondary endpoints

  • NYHA class
  • Congestion symptoms

Key results

  • Feasible IVC implantation with symptom palliation in selected patients

Why this trial matters

Early demonstration of single-site caval valve implantation.

Clinical pearls

  • Palliative — addresses congestion, not the tricuspid valve.

Limitations

  • Very small
  • Off-label device use
  • Palliative intent

Serial follow-ups & subanalyses 1

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Trial design and rationale
Study design and rationale of heterotopic implantation of the Edwards-Sapien XT valve in the inferior vena cava for severe tricuspid regurgitation.
TRICUS EURO Safety and Efficacy of the TricValve Transcatheter Bicaval Valves System (TRICUS EURO) Caval valve implantation palliates congestion when the valve itself can't be repaired or replaced. 🟢 Published1 follow-upEnrolled 2019–2021Published 2022
Estévez-Loureiro R, et al. · JACC: Cardiovascular Interventions · 2022

A dedicated bicaval valve system (SVC + IVC) that treats the congestive consequences of severe TR rather than the valve itself; improved symptoms and quality of life at 6–12 months in high-risk patients — the basis for CE mark.

Study overview

DeviceP+F TricValve
InterventionBicaval valve implantation (CAVI)
ComparatorNone (single-arm)
PopulationSevere symptomatic TR, high surgical risk, significant caval backflow
Risk groupHigh surgical risk
Sample size35 (44 pooled with first-in-human)
Enrollment2019–2021
Follow-up30 days, 6 months, 1 year
Trial typeProspective single-arm, multicenter

Inclusion criteria

—

Primary endpoint

30-day safety; 6-month quality-of-life and functional status.

Secondary endpoints

  • NYHA class
  • KCCQ
  • Caval backflow
  • Right-heart congestion markers

Key results

  • Significant quality-of-life and functional improvement at 6–12 months
  • Does not reduce true tricuspid TR — treats caval backflow/congestion
  • Mortality aligned with baseline TRI-SCORE

Why this trial matters

Offers a palliative option for patients unsuitable for TEER or orthotopic replacement.

Clinical pearls

  • Treats symptoms of congestion, not the regurgitation — set expectations accordingly.
  • Useful when coaptation gaps or anatomy preclude TEER/replacement.

Limitations

  • Small single-arm
  • Does not correct TR
  • Palliative intent

Serial follow-ups & subanalyses 1

Click a follow-up to reveal its paper links.

1-year outcomes
Bicaval TricValve implantation in patients with severe symptomatic tricuspid regurgitation: 1-year outcomes.
Tricuspid Frontier / Next-Gen Device1
TANDEM I (CroíValve) European Feasibility Study of the CroíValve DUO Transcatheter Tricuspid Coaptation Valve System A novel coaptation-valve concept to watch in the crowded tricuspid frontier. 🔵 OngoingEnrolled 2022–ongoingNot yet published

An early feasibility study of a coaptation-valve system that anchors in the SVC and places a spacer at the tricuspid annulus — a hybrid concept between caval and orthotopic approaches.

Study overview

DeviceCroíValve DUO
InterventionTranscatheter tricuspid coaptation valve
ComparatorNone (single-arm)
PopulationSevere symptomatic TR
Risk groupHigh surgical risk
Sample sizeearly feasibility
Enrollment2022–ongoing
Follow-upongoing
Trial typeProspective single-arm (EFS)

Inclusion criteria

—

Primary endpoint

Safety and performance.

Secondary endpoints

—

Key results

  • Pending — early feasibility ongoing

Why this trial matters

Represents the diversity of next-generation tricuspid approaches.

Clinical pearls

  • Combines a caval anchor with an annular coaptation element.

Limitations

  • Very early stage
  • Not yet reporting

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