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 TriClip Technique on CMRI measured RV function and morphology.

Methods and Results: Pre and postprocedural 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 Triclip-Implantation.In total, 16 patients underwent pre and postprocedural CMRI. Mean age was 78.9±0.5 years,  with 42.8% were male (n=7). All patients presented functional TR. Mean RV end-diastolic volume (RVEDV) and RV end-systolic volume (RVESV) at baseline were 192.7ml±25.85ml and 97.9ml±0.51ml, RV stroke volume (RVSV) was 94.84ml and the RV ejection fraction (RVEF) was 49.5%. After a mean follow-up of 19.6±1.1d, RVEDV and RVESV had decreased to 181.7ml±0.01ml and 85.5 ml±5.95ml, respectively. The RVSV and RVEF increased to 94.2ml±8.15ml and 53.1% ±0.14%, respectively. The quality-of-life evaluation showed an improvement of KCCQ-Score in 13/16 patients and remained unchanged or worsened in 3/16 patients.

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.