J Am Heart Assoc. 2026 Nov 12:e048944. doi: 10.1161/JAHA.125.048944. Online ahead of print.

ABSTRACT

BACKGROUND: Transcatheter tricuspid edge-to-edge repair (T-TEER) has developed as a treatment option for patients experiencing severe tricuspid regurgitation. T-TEER consistently reduces tricuspid regurgitation, but data on subsequent right heart remodeling remain limited. The aim of this study was to evaluate changes in right heart dimension and function after T-TEER using extended echocardiographic follow-up.

METHODS: The study was based on the international EuroTR (European Registry of Transcatheter Repair for Tricuspid Regurgitation), including patients undergoing T-TEER between 2016 and 2024 at 18 European centers. Eligible were patients with available baseline and follow-up (≥90 days postprocedure) echocardiographic assessment.

RESULTS: A total of 699 patients (mean age, 78±8 years; 56% women) were included in the analysis. Echocardiographic follow-up was performed at a median of 407 days (interquartile range, 205-801 days). Right heart dimensions significantly decreased: right ventricular (RV) midventricular diameter from 40.2±8.9 to 37.1±8.4 mm (P<0.001) and end-diastolic area from 28.7±9.0 to 26.2±9.6 cm² (P<0.001). Procedural success was significantly associated with positive RV remodeling (odds ratio, 1.82 [95% CI, 1.07-3.09]). For RV function, a decline of fractional area change from 37.8%±10.2% to 33.3%±10.1% (P<0.001), and tricuspid annular plane systolic excursion from 17.4±4.7 to 16.6±4.7 mm (P<0.001) was observed.

CONCLUSIONS: In the subset of surviving patients with available echocardiographic follow-up, treatment with T-TEER led to favorable long-term changes with reduced RV dimension, associated with procedural success. RV function modestly decreased, likely reflecting normalization after volume unloading.

PMID:43018056 | DOI:10.1161/JAHA.125.048944