Transcatheter Tricuspid Valve Repair Reduces Mortality and Heart Failure Hospitalizations

Transcatheter tricuspid valve repair significantly reduces heart failure hospitalizations and all-cause death in high-risk patients with severe tricuspid regurgitation, according to clinical trial data presented on August 30, 2026, at the European Society of Cardiology Congress in Munich.

The TRIC-I-HF study evaluated 360 patients with symptomatic severe tricuspid regurgitation who had a history of heart failure hospitalization during the previous year or cardio-renal or cardio-hepatic syndrome. Researchers randomly assigned participants in a 2:1 ratio to receive either transcatheter repair with a commercially available CE-marked device alongside medical therapy, or medical therapy alone. The mean patient age was 80.3 years, and 56.4% of the participants were women.

First Clinical Wins for Hard Endpoints in High-Risk Patients

According to data published simultaneously in The New England Journal of Medicine, the trial achieved its hierarchical primary endpoints. At one year, the win ratio favoring tricuspid repair over medical therapy alone was 2.42, with 16,909 wins in the intervention group compared with 6,966 in the medical therapy group.

Jörg Hausleiter, professor of medicine and deputy clinic director at the Ludwig-Maximilian University in Munich, noted during a press conference that the trial demonstrated a 60% relative reduction of the combined primary endpoint of mortality and heart failure hospitalization. When we calculated the number needed to treat to prevent one mortality or heart failure hospitalization at 1 year, the number was four, Hausleiter stated, as reported by TCTMD.

At three years, Kaplan-Meier estimates for event-free survival from death or heart failure hospitalization stood at 52.4% for the transcatheter repair group compared with 21.0% for the medical therapy group, according to data presented at the congress.

Context and Clinical Comparisons

Prior randomized controlled trials, including Tri.Fr and TRILUMINATE Pivotal, demonstrated quality-of-life improvements for patients undergoing transcatheter tricuspid valve repair, but those earlier studies failed to show reductions in hard clinical endpoints like heart failure hospitalizations or mortality.

Mohamad Alkhouli, a physician at the Mayo Clinic who was not involved in the trial, described the results to TCTMD as a major milestone for the field. It’s the first one that shows hard clinical outcome change with tricuspid valve interventions. It feels like a COAPT-like moment for the field, Alkhouli said, drawing a parallel to the landmark COAPT trial that previously established clinical benefits for transcatheter mitral valve repair.

Rebecca Hahn, a discussant for the trial from NewYork-Presbyterian/Columbia University Irving Medical Center, highlighted the careful selection of high-risk patients and the involvement of experienced heart teams at participating sites as critical elements behind the success of the study.

Impact on Quality of Life and Healthcare Costs

Severe tricuspid regurgitation is a progressive disease characterized by debilitating symptoms that severely diminish daily functioning, and many patients do not respond adequately to medical management alone. Because the average patient population in the trial was approximately 80 years old, quality-of-life improvements remain a primary goal alongside extended lifespan.

For most of the patients, the quality-of-life improvement matters more than an increased lifespan because they are usually already around 80 years of age, Hausleiter explained during the congress press briefing, as covered by Healio. For the medical field, these results will have a significant impact because we do not just want to improve quality of life; we want to see an impact on hard endpoints, on HF hospitalization. This will also have a significant impact on healthcare costs.