Transcatheter tricuspid valve intervention (TTVI) is increasingly used in patients with severe symptomatic tricuspid regurgitation (TR) who are at high surgical risk. Findings from an international six-center cohort, presented at the European Society of Cardiology (ESC) Congress 2025, show that the Society of Thoracic Surgeons Tricuspid Regurgitation (STS-TR) score substantially overestimates mortality risk in this population.

The study analyzed 457 patients treated between 2019 and 2024 with tricuspid edge-to-edge repair (T-TEER, n=243), transcatheter valve replacement (TTVR, n=131), or tricuspid annuloplasty (TTA, n=83). The mean predicted 30-day mortality was 8.16% ± 7.2%, while the observed rate was only 2.63% (p < 0.001). Calibration plots showed consistent risk overestimation across all procedure types, and discriminative ability was modest with a C-statistic of 0.68 (95% CI: 0.54–0.82).

The findings highlight that the STS-TR score, developed for surgical patients, does not reliably predict short-term outcomes after TTVI. Given the lower procedural risk compared with surgery, dedicated TTVI-specific models are needed to guide accurate risk stratification.