For years, minimally invasive repairs of a leaky tricuspid valve improved how patients felt — but never clearly reduced deaths or hospitalizations. A new trial changes that.
In TRIC-I-HF, 360 patients (mean age 80) with symptomatic severe tricuspid regurgitation and heart failure were randomized (2:1) to transcatheter tricuspid valve repair plus medical therapy, or medical therapy alone. The result: a 60% relative reduction in the combined risk of death or heart-failure hospitalization. Three-year event-free survival was 52.4% with repair versus 21% with medicine alone (hazard ratio 0.4), and the “win ratio” at one year favored repair 2.42-to-1. The findings were presented at the ESC Congress 2026 and published in the New England Journal of Medicine.
Why it’s a milestone
This is the first randomized trial to show hard-endpoint benefits — fewer deaths and hospitalizations — from tricuspid repair, going beyond the symptom and quality-of-life gains seen in earlier studies. The number needed to treat to prevent one event at a year was just four patients. These were “very sick” patients, with high NT-proBNP levels, which makes the benefit especially notable.
Why it matters
Severe tricuspid regurgitation — a poorly sealing valve on the heart’s right side — is common in older adults and has long lacked good options short of high-risk surgery. Evidence that a catheter-based repair can actually keep people alive and out of the hospital could reshape how this condition is treated.