CONGRESS ABSTRACT

Background and Aim: Proper recognition of ideal candidates for transcatheter tricuspid interventions (TTVI) represents a challenge for general practitioner, cardiologist and cardiac surgeons. Herein we reviewed clinical features of patients underwent screening for TTVI in a dedicated outpatient clinic. Methods: Thirty-eight patients (2021-2024; median age 81 y.o, 65% female) affected by severe or more tricuspid regurgitation were screened for TTVI. All patients underwent transthoracic echocardiography with focus on right ventricular function. Right heart catheterization and transesophageal echo were adopted as second level examination, after up-titration of medical therapy. Results: All cases evaluated were classified as very high surgical risk with a median TRI-SCORE of 22%, range 8-64%. Twenty-one (55%) patients were excluded for intervention due to severe right ventricular dysfunction (n=10), poor clinical conditions (n=5), patient’s wish (n=4) and two for unfavorable anatomy. Seventeen patients underwent TTVI by means of edge-to-edge repair (n=9), direct annuloplasty (n=3) and etherothopic valve implantation (n=5). Device selection was performed according to anatomic criteria and balanced with RV function. Procedural success was achieved in 93% of cases. In-hospital death was recorded in two cases, one for acute RV failure and one case for pneumonia. One late death was reported for respiratory failure at 40 days. A significant improvement of functional status was reported at follow up intervals of 3-6 and 12 months (NYHA class 3±0.5 vs 1.5±0.5) with no rehospitalization for HF. Reduction of TR was sustained up to one year. Conclusions: Patients who daily undergo evaluation for TTVI are far away from clinical trials and registries cohorts with strong impact on rate of exclusion from treatment and perioperative results. TTVI with different technique was effective in clinical improvement.