Comparison of Outcomes in Patients with and without Chronic Kidney Disease Undergoing Transcatheter Tricuspid Valve Replacementsrazm

Authors

• Sahar Razmjou, Henry Ford HealthFollow
• Arturo Giacaman Saavedra, Henry Ford HealthFollow
• Nathaniel Bowerman, Henry Ford HealthFollow
• Sureja Sundaralingam, Henry Ford HealthFollow
• Pedro Engel Gonzalez, Henry Ford HealthFollow
• Tiberio FrisoliFollow
• James Lee, Henry Ford HealthFollow
• Georgi Fram, Henry Ford HealthFollow
• John Dawdy, Henry Ford HealthFollow
• Raed Alnajjar, Henry Ford HealthFollow
• Dimitrios Apostolou, Henry Ford HealthFollow
• Alexandra DePorre, Henry Ford HealthFollow
• Brian O’Neill, Henry Ford HealthFollow
• Pedro A. Villablanca, Henry Ford HealthFollow

Recommended Citation

Razmjou S, Saavedra AG, Bowerman N, Sundaralingam S, Engel Gonzalez P, Frisoli T, Lee J, Fram G, Dawdy J, Alnajjar R, Apostolou D, Deporre A, O’Neill B, Villablanca PA. Comparison of Outcomes in Patients with and without Chronic Kidney Disease Undergoing Transcatheter Tricuspid Valve Replacement. J Soc Cardiovasc Angiogr Interv. 2026.

Document Type

Article

Publication Date

2-6-2026

Keywords

J Soc Cardiovasc Angiogr Interv

Abstract

Background: Patients with chronic kidney disease (CKD), including end-stage renal disease (ESRD), undergoing transcatheter tricuspid valve replacement (TTVR) may be at increased risk of adverse outcomes. We compared clinical outcomes after TTVR in patients with versus without CKD/ESRD.

Methods: We analyzed 145 patients who underwent TTVR for tricuspid regurgitation (TR). Patients were stratified into 2 cohorts: CKD/ESRD (dialysis dependence and/or estimated glomerular filtration rate < 30 mL/min/1.73 m2; n = 24) and no CKD/ESRD (n = 121). Baseline characteristics and clinical outcomes were compared.

Results: Patients with CKD/ESRD were slightly younger (76.3 years [IQR, 69.2-78.6] vs 80.8 years [IQR, 73.4-85.0]; P = .48) and had higher body mass index (29.7 kg/m2 [IQR, 24.2-32.2] vs 26.8 kg/m2 [IQR, 23.2-31.0]; P = .19), with significantly higher Society of Thoracic Surgeons scores (20.8 vs 12.1; P = .002) and right ventricle systolic pressure (47.5 vs 36.0 mm Hg; P < .001). Baseline New York Heart Association functional class III/IV and TR severity were similar between groups. At 30-day follow-up, all-cause mortality was numerically higher in the CKD/ESRD group (8.3% vs 3.3%; P = .25). Residual TR reduction was achieved in 100% of patients in CKD/ESRD group and 97.6% of patients in the non-CKD/ESRD group ( P = .99). Functional outcomes were comparable overall; New York Heart Association functional class III/IV persisted in 25.0% vs 19.3% ( P = .73) and median Kansas City Cardiomyopathy Questionnaire-Overall Summary scores were similar (45.8 vs 50.5; P = .57). Major bleeding occurred at similar rates between groups (12.5% vs 12.4%; P = .10), whereas new pacemaker implantation was significantly more common in the CKD/ESRD group (29.2% vs 11.6%; P = .04).

Conclusions: TTVR in patients with CKD/ESRD provides comparable functional improvement to that in patients without CKD. However, the patients with CKD/ESRD group have a significantly higher rate of pacemaker implantation, highlighting the need for individualized risk assessment and careful clinical management in this population.

ePublication

ePub ahead of print