Successful Surgical Tricuspid Valve Repair of Severe Recurrent Tricuspid Regurgitation After Transcatheter Edge-to-Edge Repair.

BACKGROUND: Transcatheter edge-to-edge repair has emerged as a minimally invasive option for patients at high surgical risk. Residual/recurrent tricuspid regurgitation (TR) is associated with high morbidity and mortality. CASE SUMMARY: A 79-year-old woman developed recurrent severe TR after initially successful TriClip implantation. Symptoms progressed despite optimal medical therapy. As redo tricuspid transcatheter edge-to-edge repair (T-TEER) was not feasible, the patient underwent surgical intervention. Following careful clip removal, surgical tricuspid valve (TV) repair was successfully performed. At 7-month follow-up, echocardiography confirmed a stable repair with mild TR, and the patient reported substantial symptomatic improvement. DISCUSSION: This case shows that surgical TV repair can be a safe and effective treatment option for recurrent TR after T-TEER. With the increasing use of transcatheter therapies, awareness of surgical bailout options will become increasingly important. TAKE-HOME MESSAGE: Surgical TV repair may represent a safe and effective strategy in selected patients with recurrent TR after T-TEER.