Effects of Transcatheter Tricuspid Edge‐to‐Edge Repair on Right Heart Dimension and Function

Background Transcatheter tricuspid edge‐to‐edge repair (T‐TEER) has developed as a treatment option for patients experiencing severe tricuspid regurgitation. T‐TEER consistently reduces tricuspid regurgitation, but data on subsequent right heart remodeling remain limited. The aim of this study was to evaluate changes in right heart dimension and function after T‐TEER using extended echocardiographic follow‐up. Methods The study was based on the international EuroTR (European Registry of Transcatheter Repair for Tricuspid Regurgitation), including patients undergoing T‐TEER between 2016 and 2024 at 18 European centers. Eligible were patients with available baseline and follow‐up (≥90 days postprocedure) echocardiographic assessment. Results A total of 699 patients (mean age, 78±8 years; 56% women) were included in the analysis. Echocardiographic follow‐up was performed at a median of 407 days (interquartile range, 205–801 days). Right heart dimensions significantly decreased: right ventricular (RV) midventricular diameter from 40.2±8.9 to 37.1±8.4 mm ( P <0.001) and end‐diastolic area from 28.7±9.0 to 26.2±9.6 cm 2 ( P <0.001). Procedural success was significantly associated with positive RV remodeling (odds ratio, 1.82 [95% CI, 1.07–3.09]). For RV function, a decline of fractional area change from 37.8%±10.2% to 33.3%±10.1% ( P <0.001), and tricuspid annular plane systolic excursion from 17.4±4.7 to 16.6±4.7 mm ( P <0.001) was observed. Conclusions In the subset of surviving patients with available echocardiographic follow‐up, treatment with T‐TEER led to favorable long‐term changes with reduced RV dimension, associated with procedural success. RV function modestly decreased, likely reflecting normalization after volume unloading.