Background:

Tricuspid regurgitation (TR) is recognized as major public health concern with significant impact on morbidity and mortality. Multiple innovative approaches for transcatheter tricuspid valve repair (TTVR) are currently under development, however their impact on cardiac function and outcome is still unclear. Cardiac Magnetic Resonance Imaging (CMRI) is considered as reference technique for right ventricular (RV) volumetric and functional measurements. Therefore, the purpose of the present study was to evaluate the impact of TTVR with the Tri-Clip Technique on CMRI measured RV function and morphology.

Methods:

Pre and post procedural to TTVR, RV function and morphology were evaluated in CMRI. Clinical outcome and quality of life were evaluated based on New York Heart Association (NYHA) class and the KCCQ-Score at baseline and within 30 days after Tri-clip Implantation.

Results:

In total, 20 patients underwent pre- and postprocedural CMR, mean age 76,50 ±0,01, 35% male (n=7), 65% female (n=13). All patients presented functional TR. The mean RVEDV and RVESV before the Clipping were 190,3ml ±0,029ml and 97,5ml ±0,01ml, the RVSV was 92,8ml±0,049ml and the RVEF was 48,9%±0,03. After am mean follow-up of 28,29 ± 2,09 days, RVEDV and RVESV decreased to 177,0ml (-13,3ml) ± 0,058ml and 84,0ml (-13,5ml) ± 0,088ml the RVSV increased to 93,1ml (+0,3ml) ±0,049ml and the RVEF to 52,6% (+3,7) ±0,02. The quality of life evaluation showed within 20 patients an improvement for 16 of them, a worsening for only 2 of them and no difference for 2 of them. A Z-Test as been used with a confidence interval of 95%, also a p<0,05.

Conclusion:

In this pilot study, we observed an improvement of RV function as well as a reduction of RVEDV and RVESV after TTVR. These functional and morphometric changes induced by TTVR suggest a more efficient RV stroke work. This was associated with an improved quality of life according to KCCQ-Score in the majority of patients.