Temporal Trends in Transcatheter Tricuspid Valve Interventions After FDA Approval in the United States
Abstract
Background Transcatheter tricuspid valve interventions (TTVIs) have recently received commercial approval; however, contemporary adoption trends in early postapproval phase are not well described. Objectives The objectives of the study were to characterize trends in utilization of transcatheter tricuspid edge-to-edge repair (T-TEER) and transcatheter tricuspid valve replacement (TTVR) and to describe baseline patient characteristics and in-hospital outcomes. Methods We performed a retrospective cohort study using the Vizient Clinical Data Base including patients who underwent T-TEER or TTVR between October 2024 and December 2025. Monthly procedural trends, baseline characteristics, and in-hospital outcomes were evaluated. Results The study included 2,143 T-TEER procedures performed at 180 implanting hospitals; median annualized hospital volume 6.4 (IQR: 2.4-13.6) and 1,301 TTVR procedures performed at 113 implanting hospitals; median annualized hospital volume 6.4 (IQR: 3.2-11.2). Overall monthly volumes increased for both T-TEER (128 in October 2024 to 156 in December 2025; P for trend = 0.004) and TTVR (60 in October 2024 to 111 in December 2025; P for trend <0.001). The proportion of TTVR among all TTVI increased over time (from 31.9% to 41.6%; P for trend = 0.006). Baseline patient comorbidities of patients undergoing TTVI were similar to pivotal trial populations. In-hospital mortality was 0.5% following T-TEER and 2.0% following TTVR. The incidence of major bleeding was 6.0% and 12.4% after T-TEER and TTVR, respectively. Among TTVR patients, 11.3% required new pacemaker implantation. Conclusions There is increased adoption of both T-TEER and TTVR in early commercial experience with clinical characteristics of treated patients similar to those enrolled in pivotal trials. In-hospital outcomes were overall favorable supporting the generalizability of the pivotal trial findings to contemporary practice.