Catecholamine use and post-interventional patient care after transcatheter tricuspid valve replacement

Introduction Severe tricuspid regurgitation (TR) is a prevalent condition in the general population and is associated with high morbidity and mortality. Interventional treatment of TR is increasingly performed. Transcatheter tricuspid valve replacement (TTVR) is a recently developed technique that can eliminate TR. Purpose Investigating the impact of eliminating high-grade TR on post-interventional patient care, acute heart failure, and catecholamine use in patients treated with TTVR. Methods The current study included all patients treated with TTVR at a single center. Post-interventional patient care was conducted according to established clinical routines. Blood lactate levels were measured using blood gas analyses. Patients were divided into two groups: the first group required catecholamines for more than one day after the procedure, while the second group did not. Clinical, laboratory, invasive hemodynamic, and echocardiographic parameters were compared between the two groups. Results A total of 29 patients were treated over approximately one year. The baseline TR was graded as severe to torrential in all patients. All patients showed a TR grade of less than 1 after TTVR. Nine patients needed catecholamines more than one day after the procedure, which could be tapered over the next 16 days. No patient died during the hospital stay. We did not observe a relevant increase in blood lactate levels after TTVR. Comparisons between the groups revealed a significantly lower left ventricular (LV) ejection fraction (EF) before TTVR in group 1. Left ventricular volume increased more in group 1 than in group 2 after TTVR. Conclusion TTVR may prolong catecholamine use but is not linked to fatal cardiogenic shock. Low LV EF best predicts post-TTVR catecholamine need. Patients who rely on catecholamines for an extended period after TTVR exhibit increased LV volume.