Cardiac Remodeling Following Transcatheter Tricuspid Valve Annuloplasty for Tricuspid Regurgitation: A Real-World, Multicenter Analysis.

BACKGROUND

Transcatheter tricuspid valve annuloplasty (TTVA) with the Cardioband has proved to be safe and effective in acutely reducing tricuspid regurgitation (TR). However, long-term outcomes, especially regarding right heart remodeling (RHR), are scarce.

OBJECTIVES

The aim of this study was to assess long-term efficacy as well as RHR following TTVA.

METHODS

This retrospective, multicenter study included consecutive patients undergoing TTVA for severe TR at 2 German high-volume centers from 2019 to 2023. Right atrial and right ventricular (RV) parameters and NYHA functional class were assessed at baseline and follow-up.

RESULTS

A total of 156 patients were included, and the median time to follow-up was 435 days (Q1-Q3: 156-704 days). TR reduction to ≤2+ was observed in 71% and NYHA functional class improved to ≤II in 68% (P < 0.001 for both). Compared with baseline, right atrial area (36.0 ± 10.1 cm2 vs 30.4 ± 10.7 cm2), RV length (67.5 ± 9.4 mm vs 63.7 ± 9.1 mm), RV midventricular dimension (42.6 ± 8.6 mm vs 35.6 ± 7.8 mm), and RV basal dimension (47.8 ± 6.8 mm vs 42.6 ± 7.5 mm)were significantly reduced at follow-up (P < 0.001 for all). Notably, torrential to severe TR reduction still yielded remodeling (RV basal diameter 50 ± 8.1 mm vs 44 ± 8 mm; P = 0.007). RHR was associated with a decrease in vena contracta width (OR: 1.14; 95% CI: 1.03-1.30; P = 0.015).

CONCLUSIONS

TTVA is associated with a significant and sustained reduction of TR for more than 1 year. Additionally, patients demonstrated distinct positive cardiac remodeling and functional improvement.