Changes in right ventricular function and clinical outcomes following tricuspid transcatheter edge‐to‐edge repair

Abstract

AbstractAimsPrognostic impact of post‐procedural changes in right ventricular (RV) function after tricuspid transcatheter edge‐to‐edge repair (T‐TEER) is still unclear. We investigated association of RV function and its post‐procedural changes with clinical outcomes in patients undergoing T‐TEER.Methods and resultsWe retrospectively analysed 204 patients who underwent T‐TEER and echocardiographic follow‐up at 3 months after T‐TEER. RV function was assessed by RV fractional area change (RVFAC), and RV dysfunction was defined as RVFAC <35%. Patients with an increase in RVFAC from baseline to the follow‐up were considered as RV responders. Patients were divided into four groups according to baseline RVFAC and the RV responder. The primary outcome was a composite of mortality and hospitalization due to heart failure within 1 year. Forty‐five of 204 patients (22.1%) had RVFAC <35% at baseline, and 71 (34.8%) were RV responders. The association between the RV responder and the composite outcome had a significant interaction with RVFAC at baseline. Among patients with baseline RVFAC <35%, RV responders had a lower risk of the composite outcome than RV non‐responders, while this association was not significant in those with baseline RVFAC ≥35%. Among patients with baseline RVFAC <35%, a smaller RV diameter and a greater reduction of tricuspid regurgitation were predictors for the RV responder.ConclusionPost‐procedural increase in RVFAC after T‐TEER is associated with improved outcomes in patients with RV dysfunction. The factors related to the increase in RVFAC may support patient selection for T‐TEER in patients with RV dysfunction.