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Tricuspid transcatheter edge-to-edge repair acutely reduces right ventricular preload and increases forward stroke volume, reflecting substantial right ventricular unloading. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

May 1, 20260 citations

Acute Impact of Transcatheter Edge-to-Edge Repair of Tricuspid Regurgitation on Right Ventricular Hemodynamics.

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Severe tricuspid regurgitation (grades III-IV) (n=9). Intervention: Tricuspid transcatheter edge-to-edge repair vs. Baseline (before procedure). Primary outcome: Acute hemodynamic effects on right ventricular function (p==0.03).

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JRJan‐Christian ReilHeart and Diabetes Center North Rhine-Westphalia PSPaul Steendijk VSVasco Sequeira

Key Result

Tricuspid transcatheter edge-to-edge repair acutely reduced right ventricular preload and increased forward stroke volume, reflecting substantial RV unloading (P=0.03).

Key Points

To quantify the acute hemodynamic effects of tricuspid transcatheter edge-to-edge repair on right ventricular function.
Nine patients with severe tricuspid regurgitation (grades III-IV) underwent invasive and echocardiographic assessment.
A 7-electrode conductance catheter recorded pressure-volume signals in the RV before and after the procedure.
Steady-state RV pressure-volume loops and echocardiographic data were obtained.
Forward stroke volume increased after the procedure.
Preload was significantly reduced, indicating an improved preload reserve.
Contractility and stroke work remained unchanged, reflecting substantial RV unloading.

Study Design

Type

Observational (n=9)

Structured PICO

Does tricuspid transcatheter edge-to-edge repair acutely improve right ventricular hemodynamics in patients with severe tricuspid regurgitation?

Population

9 patients with severe tricuspid regurgitation (grades III-IV)

Intervention

Tricuspid transcatheter edge-to-edge repair

Comparator

Pre-procedural baseline (intra-patient before-and-after comparison)

Outcome

Acute right ventricular function and hemodynamics (including forward stroke volume, contractility, stroke work, and preload) measured via simultaneous invasive pressure-volume analysis and 3-dimensional echocardiographysurrogate

Tricuspid transcatheter edge-to-edge repair acutely improves right ventricular hemodynamics by reducing preload and increasing forward stroke volume without altering contractility.

Main Result

p-value: p==0.03

Abstract

BACKGROUND: Tricuspid transcatheter edge-to-edge repair is an established therapy for high-grade tricuspid regurgitation, but its acute impact on right ventricular (RV) mechanics remains incompletely understood. The aim of the study was to quantify the acute hemodynamic effects of tricuspid transcatheter edge-to-edge repair on RV function using invasive pressure-volume analysis. METHODS: Nine patients with severe tricuspid regurgitation (grades III-IV) underwent simultaneous invasive and echocardiographic assessment of RV function. A 7-electrode conductance catheter positioned in the RV continuously recorded pressure-volume signals, calibrated against 3-dimensional echocardiographic RV volumes. Steady-state RV pressure-volume loops and RV echocardiography were obtained before and after the procedure. RESULTS: =0.03), reflecting substantial RV unloading. CONCLUSIONS: Successful tricuspid transcatheter edge-to-edge repair is accompanied by economization of myocardial work through redirection of blood flow into the pulmonary circulation. Forward stroke volume increased while contractility and stroke work remained unchanged. Preload was significantly reduced, indicating an improved preload reserve.

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Cite This Study

Reil et al. (Wed,) conducted a observational in Severe tricuspid regurgitation (grades III-IV) (n=9). Tricuspid transcatheter edge-to-edge repair vs. Baseline (before procedure) was evaluated on Acute hemodynamic effects on right ventricular function (p==0.03). Tricuspid transcatheter edge-to-edge repair acutely reduced right ventricular preload and increased forward stroke volume, reflecting substantial RV unloading (P=0.03).

synapsesocial.com/papers/69f44390967e944ac5566c8d https://doi.org/https://doi.org/10.1161/jaha.125.047560

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