Key result
TTVR in a single case complicated by acute severe MR that improves by discharge.
Why the study?
Transcatheter tricuspid valve replacement is an emerging option for severe tricuspid regurgitation in patients ineligible for surgery, but acute mitral regurgitation following the procedure had not been reported.
Case Report (n=1)
Answers are grounded in this paper and cite their sources.
Abrupt elimination of tricuspid regurgitation via TTVR can lead to acute, transient worsening of mitral regurgitation due to increased left ventricular preload, highlighting the need for caution and potential volume unloading in patients with pre-existing left ventricular dysfunction.
Background Transcatheter tricuspid valve replacement (TTVR) has emerged as a therapeutic option for patients with severe tricuspid regurgitation (TR) who are ineligible for surgery. Case Summary We report the first case of acute development and transient resolution of severe mitral regurgitation (MR) following TTVR device implantation. Baseline transthoracic echocardiography (TTE) showed torrential TR and mild to moderate MR. Immediately after TTVR-device implantation, transesophageal echocardiography (TOE) revealed severe MR. Over the following days, MR gradually improved, and TTE at discharge showed only mild to moderate MR. Discussion This case illustrates that abrupt elimination of TR can lead to acute worsening of MR, likely precipitated by an abrupt increase in left ventricular preload in the presence of diastolic dysfunction. In conclusion, caution is warranted in patients with pre-existing left ventricular dysfunction undergoing TTVR, as the procedure may exacerbate functional MR. Periprocedural volume unloading may help ameliorate the impact of acute hemodynamic changes.
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Rubinić et al. (2026) conducted a case report in Severe tricuspid regurgitation (n=1). Transcatheter tricuspid valve replacement (TTVR) was evaluated on Development of acute mitral regurgitation. Transcatheter tricuspid valve replacement in a single patient led to acute development of severe mitral regurgitation that gradually improved to mild-to-moderate by discharge.
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