Backround: Severe tricuspid regurgitation (TR) is a common disease accompanied with increased mortality and morbidity, as well as restricted quality of life. In the last years, the transcatheter percutaneous edge-to-edge repair for TR (T-TEER) has evolved as a feasible Intervention to reduce symptoms. Little is known about the changes of right heart function and structure following this intervention.

Methods: We included all patients treated with T-TEER at our center from June 2016 until December 2019 in the “MAinz Retrospective Registry for Tricuspid INtervention" (MARRTIN). Systems used were either MitraClip (off-label), TriClip, or PASCAL. Patients were followed for 1 year, including clinical status, laboratory measurements, transthoracic echocardiography (TTE) and mortality.

The aim of this study was to observe the impact of T-TEER on the right heart structure and function, and whether possible changes could be associated to patient ́s clinical and laboratory values.

Results: In total there were 185 patients treated with T-TEER in this period of time. One- year follow-up was available in 76 cases for paired analysis. Mean patient ́s age was 79.7 ± 6.3 years and 63.2% were women. The median TR-grade was 4 with a reduction to median grade 2 after T-TEER.
In long-term course there were significant reductions of tricuspid annular diameters, right ventricular end diastolic diameter (RVEDD), and right atrial areas, respectively. Also, the right heart function significantly improved (RV-FAC 36,5 ± 6,2 % vs. 39 ± 7,5 %). While observing a significant reduction of BNP-, CRP- and y-GT-values, kidney function measured by estimated glomerular filtration rate, did not improve. The 1-year survival was 90,7%. Unexpected rehospitalization of any cause was observed in 17 cases (9,2%) and 3 deaths (1,6%) within 30 days after T-TEER. In 10 of 185 (5,4%) cases a clip-detachment was observed.

Conclusion: The use of T-TEER proved to be safe for severe TR showing stable long-time results. There was an objectifiable improvement of right heart dimensions, as well as function. Also we noted improvements of inflammatory markers and laboratory values of heart failure. Overall, T-TEER may improve the maladaptive remodeling of the right heart in patients at high risk for cardiac surgery suffering from TR.