Effect of Clover versus Zipping on Annular Geometry and Dynamics in Tricuspid Edge-to-Edge Repair

Clover configuration in a sheep model of functional tricuspid regurgitation produces an acute annuloplasty effect by selectively reducing septal-lateral annular diameter (30±2 to 27±1 mm; p=0.001).

• Why it matters: Some patients show an additional annuloplasty effect after transcatheter edge-to-edge repair, but which device configuration yields this geometry change is unclear.
• What they did: Ten adult sheep with pulmonary artery banding–induced right ventricular failure and functional TR received two Abbott XTW clips in either Zipping (n=5) or Clover (n=5), with echocardiography and sonomicrometry before and after implantation.
• The result: In all animals, two clips reduced TR severity (3.6±0.5 to 1.3±1.1; p=0.01) and septal-lateral annular diameter overall (29.2±2.2 to 26.7±2.9 mm; p=0.01), with the significant septal-lateral reduction occurring only with Clover.