A minimally invasive procedure to repair a badly leaking heart valve has shown an important benefit in a major randomized clinical trial.
The TRIC-I-HF trial, published in the New England Journal of Medicine and presented at the European Society of Cardiology Congress 2026, studied people with severe tricuspid regurgitation who were at high risk of heart-failure complications.
The tricuspid valve sits between the two chambers on the right side of the heart. When it does not close properly, blood leaks backward each time the heart contracts.
Severe leakage can contribute to breathlessness, leg swelling, fluid build-up, repeated hospital admissions and, in advanced cases, death.
For many older or medically fragile patients, open-heart surgery may be too risky. Medicines can help control symptoms such as fluid retention, but they do not repair the faulty valve itself.
What did the trial test?
The study included 360 patients with severe symptomatic tricuspid regurgitation.
They were randomly assigned to receive either catheter-based tricuspid valve repair plus medical treatment, or medical treatment alone.
The average age of the participants was just over 80 years.
The catheter procedure reaches the heart through blood vessels, avoiding open-heart surgery. It is designed to improve how well the valve closes and reduce backward leakage of blood.
What did researchers find?
The catheter-repair group did better overall.
At three years, about 52% of patients who received the repair were still alive and had not been hospitalised for heart failure, compared with about 21% of patients treated with medical therapy alone.
This is important because previous studies had already suggested that catheter-based tricuspid treatment could improve symptoms and quality of life.
The new trial provides stronger evidence that the treatment may also reduce serious outcomes such as heart-failure hospitalisation and death.
Was the procedure risk-free?
No.
Serious complications related to the treatment occurred in a minority of patients during the first month after the procedure.
That means this is not a treatment that should automatically be offered to every person with tricuspid regurgitation.
The patients in this trial were carefully selected and treated in experienced heart-valve centres.
Why does this matter?
Severe tricuspid regurgitation has historically been more difficult to treat than some other heart-valve diseases.
Many affected patients are older and have several other medical problems, which can make conventional surgery unsafe.
A catheter-based option may therefore offer an important alternative for selected patients.
The European Society of Cardiology said the findings could influence future treatment recommendations.
What happens next?
Further studies and longer follow-up will help doctors understand which patients benefit most, when treatment should be offered, and how different catheter-based repair systems compare.
For now, the trial provides strong evidence that catheter repair can improve important outcomes in carefully selected people with severe tricuspid regurgitation.
It does not mean that every leaking tricuspid valve needs a procedure.
Evidence so far
Evidence strength: Strong
This was a randomized clinical trial involving 360 patients and was published in a major peer-reviewed medical journal.
However, the participants were mainly elderly, high-risk patients treated at specialist centres, so the findings may not apply equally to every person with tricuspid valve disease.
