Abstract 16432: Physiological and Clinical Consequences of Relief of Right Ventricular Volume Overload After Transcathether Repair of the Tricuspid Valve - Insights From Cardiac Magnetic Resonance

• Published in: Circulation (New York, N.Y.) N.Y.), 2018-11, Vol.138 (Suppl_1 Suppl 1), p.A16432-A16432
• Main Authors: Lurz, Philipp C, Rommel, Karl, Besler, Christian, Blazek, Stephan, Noack, Thilo, Borger, Michael, Thiele, Holger
• Format: Article
• Language: English
• ISSN: 0009-7322; 1524-4539

BackgroundSignificant tricuspid regurgitation(TR) is a major determinant of morbidity and prognosis in advanced heart failure patients. Treatment options are limitied and assessments of the right ventricular performance after insufficiency correction have been hampered by the confounding effects of open-heart surgery and limitations of echocardiography. Percutaneous tricuspid valve repair(TVR) has emerged as a new catheter-based treatment option in high risk patients. This technique also provides a unique model to study the impact of chronic RV volume overload on biventricular function, without the confounding effects of surgery. Cardiac magnetic resonance imaging(CMR) has been established as the reference method for the assessment of biventricular volumes and function, also allowing for hemodynamic assessment and quantification of valvular insufficiencies. We sought to characterize the clinical outcomes and hemodynamic effects of interventional TVR within one and six months after treatment with the use of CMR.Methods and ResultsTwenty-nine patients (78.4±4.0 years) with severe isolated TR and high surgical risk underwent interventional edge-to-edge TVR using the MitraClip© system. Clinical Follow-UP including 6-minute-walk-test was realized 32 (5-47) days and 185 (162-188) after the intervention. Eighteen patients underwent repeated CMR imaging. Decompensation hospitalization rate was reduced from 83 to 22% whithin 6 months prior versus after the procedure. Two patients died (7%). After TVR patients experienced a significant improvement in symptoms with reduction of NYHA class (p