{"id":"d16e45dd83aa","type":"article","url":"https://hartvaat.nl/2026/03/23/fate-register-mislukte-transkatheter-tricuspidalisreparatie-t-teer/","title":"FATE-register: mislukte transkatheter-tricuspidalisreparatie (T-TEER)","title_en":"","category":"hartfalen","category_label":"Hartfalen","professions":["cardioloog"],"tags":[],"journal":"JACC. Cardiovascular interventions","doi":"10.1016/j.jcin.2026.01.285","source_url":"https://doi.org/10.1016/j.jcin.2026.01.285","authors":["Federico De Marco","Gianmaria Calamita","Valentina Ardizzone","Mirjam Gauri Winkel","Mohammad Kassar","Fabien Praz","Nicolas M Van Mieghem","Joris F W Ooms","Muhammed Gerçek","Felix Rudolph","Marianna Adamo","Augustin Coisne","Jérémie Arlanda","Philipp Lurz","Rodrigo Estévez-Loureiro","Neil P Fam","Joachim Schofer","Christina Brinkmann","Marina Urena","Gregory Ducrocq","Jan-Malte Sinning","Tobias Geisler","Alessia Azzano","Elvis Brscic","Antonella Millin","Azeem Latib","Maurizio Taramasso","Antonio Popolo Rubbio","Francesco Bedogni","Stephanie Brunner","Stefan Toggweiler","Martin J Swaans","Leo Timmers","Francesco Giannini","Alfonso Ielasi","Omar Oliva","Nicolas Dumonteil","Didier Tchetchè","Dabit Arzamendi","Giulia Maisero","Giuseppe Tarantini","Gabriele Crimi","Italo Porto","Fausto Castriota","Luca Ferri","Matteo Montorfano","Alessandro Sticchi","Maria Lopez-Laporte","David Messika-Zeitoun","Marino Labinaz","Peter Lüdike","Horst Sievert","Giulia Antonelli","Fabio Fazzari","Cristina Ferrari","Antonio Mangieri"],"significance":7,"published":"2026-03-23","source_date":"2026-03-23","image":"","kennis":["https://hartvaat.nl/kennis/farmacologie/betablokkers-cardiale-indicaties/"],"congress":"","summary_en":"The international FATE registry examined device-related failures of transcatheter edge-to-edge tricuspid valve repair (T-TEER). Across 2,278 procedures at 31 centres, 123 failures occurred (5.4%; mostly single-leaflet device attachment, 75%), often recognised early and with severe residual regurgitation in 73%. Reintervention (in 46%) achieved greater tricuspid-regurgitation reduction and more favourable right-atrial remodelling than medical therapy, but the composite of death or heart-failure rehospitalisation remained high (38%) and did not differ between strategies. Higher TRI-SCORE, acute kidney injury and greater residual regurgitation predicted adverse outcomes.","created":"2026-07-03T10:32:17Z","updated":"2026-07-03T13:31:15Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Het internationale FATE-register onderzocht apparaat-gerelateerde mislukkingen van transkatheter edge-to-edge-reparatie van de tricuspidalisklep (T-TEER). Onder 2.278 ingrepen in 31 centra traden 123 mislukkingen op (5,4%; meestal eenbladige fixatie, 75%), vaak vroeg herkend en met ernstige restregurgitatie in 73%. Reïnterventie (bij 46%) gaf meer reductie van de tricuspidalisinsufficiëntie en gunstiger remodellering van het rechter atrium dan medicamenteuze therapie, maar het gecombineerde eindpunt van sterfte of hartfalenheropname bleef hoog (38%) en verschilde niet tussen beide strategieën. Een hogere TRI-SCORE, acute nierschade en ernstigere restregurgitatie voorspelden een ongunstige uitkomst.","abstract_original":"BACKGROUND: Tricuspid regurgitation (TR) is linked to significant morbidity and mortality. Tricuspid transcatheter edge-to-edge repair (T-TEER) provides a less invasive option for high-risk patients, but real-world data on device failure mechanisms and outcomes remain limited. OBJECTIVES: The aim of this study was to investigate the incidence, management, and outcomes of T-TEER device-related failures due to loss of leaflet insertion, single-leaflet device attachment, or device embolization, offering insights into these adverse events. METHODS: The retrospective, multicenter FATE (Failed Tricuspid Transcatheter Edge-to-Edge) registry identified all device-related failures associated with moderate or greater residual or recurrent TR among 2,278 consecutive T-TEER procedures performed at 31 centers from 2017 to 2024. Failure mechanisms were classified by multiparametric echocardiography. Coprimary endpoints were the incidence and management of device-related failure and the composite of death or heart failure rehospitalization. RESULTS: Among 2,278 T-TEER procedures, 123 device-related failures (5.4%) were identified (loss of leaflet insertion, 24%; single-leaflet device attachment, 75%; embolization, 1%), mostly diagnosed early and associated with severe or greater TR in 73%. Management was medical therapy in 54% and reintervention in 46%. Reintervention achieved greater TR reduction and right atrial reverse remodeling than medical therapy, but over a median follow-up period of 255 days, the composite of death or heart failure rehospitalization remained frequent (38.2%) and did not differ between strategies. Higher TRI-SCORE, acute kidney injury, and greater discharge TR severity independently predicted adverse outcomes. CONCLUSIONS: Device-related failure after T-TEER is uncommon but clinically relevant. Reintervention achieves greater TR reduction and right atrial reverse remodeling than medical therapy, but events remain similar between both strategies."}