Key result
Transcatheter tricuspid valve pop-off zone perforation creates mild TR to limit RV afterload increases.
Why the study?
Accurate assessment of right ventricular function is limited by concomitant tricuspid regurgitation, necessitating alternative measurement methods contextualized to pulmonary pressure in severe TR patients.
Case Report (n=1)
Creating mild residual tricuspid regurgitation during transcatheter tricuspid valve replacement may help mitigate the sudden increase in right ventricular afterload and preserve right ventricular systolic function.
Alerts clinicians to TR confounding RV assessment in PH/VHD; supports research into validated, pressure-contextualized systolic metrics.
Right ventricular (RV) function is an important determinant of prognosis in pulmonary hypertension and valvular heart disease. The accurate assessment of RV function is however limited by the presence of concomitant tricuspid regurgitation (TR). Implantation of a novel transcatheter tricuspid valve device in this case highlights the importance of recognizing these limitations, and the need to define alternative ways to measure RV systolic function, contextualized to pulmonary pressure in patients with severe TR. It also demonstrates the clinical potential of perforation of the pop-off zone in this prosthesis, to create mild residual TR, thereby reducing the increase in RV afterload of this intervention, and its impact on RV systolic function.
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Kempton et al. (2025) conducted a case report in severe tricuspid regurgitation (n=1). Novel transcatheter tricuspid valve replacement was evaluated. Perforation of the pop-off zone in a novel transcatheter tricuspid valve prosthesis created mild residual TR, reducing the increase in RV afterload and its impact on RV systolic function.
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