1060 How to Evaluate Right Ventricular Function in Patients With Significant Tricuspid Regurgitation: Preliminary Data Before and After Triclip Implantation

Abstract

Objective transcatheter tricuspid valve repair (TTVR) has recently become available as a treatment option for patients with symptomatic significant tricuspid regurgitation (TR) not eligible for tricuspid valve surgery. In the absence of a single reliable measure of the RV systolic function, a number of surrogate echocardiographic parameters have been proposed for clinical use (tricuspid annular plane systolic excursion (TAPSE), RV fractional area change (FAC), peak S wave velocity of the lateral tricuspid annulus by tissue Doppler imaging (S’ RV-TDI) and RV 2D-FWS. At present, TTVR is not recommended in patients with severe PH and poor RV function, but exact cut-offs when TTVR should be rejected are lacking. Aim of this study was to assess RV function before and after Triclip implantation. Materials and methods from June 2021 to June 2022 clinical and echocardiographic data of 8 patients with TR who underwent TTVR intervention in our division were evaluated for RV function. TAPSE, FAC, S’RV-TDI, RV GS and RV FWS at baseline and 1 month of follow up were assessed. Continuous variables are presented as mean ± standard deviation (SD). Categorical variables were presented as frequencies and percentages. Results the mean values of RV function assessed before and after Triclip implantation were respectively (18,75 mm± 4,04 vs 18,38 mm ± 3,34) for TAPSE, (10,50 cm/sec± 2,33 vs 10,38 cm/sec ± 1,19) for S’ RV-TDI, (38% ± 0,05 vs 37% ± 0,04) for FAC, and (-17% ± 0,03 vs -19% ± 0,02) for RV FWS. The number of patients that show at baseline RV dysfunction, according to the cut-offs indicated from guidelines, were 4 for TAPSE; 3 S’ RV-TDI; 1 for FAC and 7 for RV 2D-FWS. At 1 month of follow-up, patients with ventricular dysfunction were respectively 3,2,2,4. Conclusions in the presence of significant TR, the accurate assessment of RV function becomes even more challenging as a result of the load and angle dependency of TAPSE, RVFAC. Significant TR results in a reduction in RV afterload, which may preserve the aforementioned markers of RV function even when contractility is impaired. Probably RV 2D-STE is less angle and load dependent than traditional RV function indices and less confounded by RV geometry and passive motion.