Advancing the Field of Valve Interventions for Mitral and Tricuspid Regurgitation

A pair of late-breaking studies presented at the 2024 European Society of Cardiology Congress (ESC) have significantly advanced the field of valve repair, Javed Butler, MD, MPH, MBA, professor of medicine at University of Mississippi and president of the Baylor Scott and White Research Institute, told The American Journal of Managed Care^®.

In the RESHAPE-HF2 trial (NCT02444338) on which Butler is an investigator, adding mitral transcatheter edge-to-edge repair (M-TEER) to medical therapy for moderate to severe functional mitral regurgitation led to a lower rate of initial or recurrent hospitalizations for heart failure or cardiovascular death and a lower rate of total hospitalizations for heart failure at 24 months.¹ Patients also showed better health status at 12 months following transcatheter mitral-valve repair compared with those receiving medical therapy alone.

“The interesting question this trial raised is that, up until now, all the trials were in severe mitral regurgitation, whereas this trial included patients with moderate mitral regurgitation, as well,” Butler said. “So now the question is, should we wait only for severe, or should we do moderate as well? I think we will learn more about that in the future.”

Additionally, the Tri.fr study on tricuspid transcatheter edge-to-edge repair (T-TEER) found that optimal medical therapy plus T-TEER reduced the severity of secondary tricuspid regurgitation and improved quality of life after 1 year for patients with severe tricuspid regurgitation.²

“On the tricuspid side, their preliminary results are very encouraging, showing potential for long-term benefit in terms of clinical outcomes, as well,” Butler said. “Now they presented just the first cut data, but the 2-year and 4-year results will come out in the future, so we will understand more.”

While previous trials of M-TEER and T-TEER have led to questions surrounding the potential benefits of these procedures, the pair of trials presented at ESC 2024 demonstrate their potential, Butler said.

“My summary of this whole thing is that both the trials are positive,” Butler said. “Both the trials are showing that valve interventions on both the mitral and the tricuspid valves seem like a good idea. I think the clinical uptake will increase, and then the indication will expand, and more research will be done in adjacent patient populations.”

References

1. Transcatheter edge-to-edge repair is better than medical therapy alone in patients with heart failure and mitral regurgitation. News release. European Society of Cardiology. August 31, 2024. Accessed September 27, 2024. https://www.escardio.org/The-ESC/Press-Office/Press-releases/Transcatheter-edge-to-edge-repair-is-better-than-medical-therapy-alone-in-patients-with-heart-failure-and-mitral-regurgitation

2. New evidence for the benefits of transcatheter edge-to-edge repair in secondary tricuspid regurgitation. News release. European Society of Cardiology. August 31, 2024. Accessed September 27, 2024. https://www.escardio.org/The-ESC/Press-Office/Press-releases/New-evidence-for-the-benefits-of-transcatheter-edge-to-edge-repair-in-secondary-tricuspid-regurgitation