TCT-171 Baseline Invasive Hemodynamics and Clinical Outcomes in Transcatheter Tricuspid Valve Replacement Using the EVOQUE System

Document Type

Conference Proceeding

Publication Date

10-29-2024

Publication Title

J Am Coll Cardiol

Abstract

Background: Transcatheter tricuspid valve replacement (TTVR) with the Evoque valve represents a newly commercially available non surgical therapy for severe tricuspid regurgitation (TR) in the United States. There is minimal data on the significance of pulmonary hypertension (PH) and right ventricular dysfunction (RVD) in patients undergoing TTVR. Methods: Patients who underwent TTVR at Henry Ford Hospital in Detroit during February-May 2024 (n = 28) were included. We examined how right heart catheterization metrics of PH and RVD—pulmonary vascular resistance (PVR), pulmonary artery pulsatility index (PAPi), and pulmonary capillary wedge pressure (PCWP)—correlated with both procedural success and a composite outcome of death or heart failure hospitalization. Results: The cohort had a median PVR 2.4 (IQR 1.3-2.9), PCWP 10 (IQR 8.8-19.3), and PAPi 2.1 (IQR 1.4-4.0). For those with complete data, 5/20 (25%) had elevated PVR >3.0 and 7/20 (35%) had elevated PCWP >15. There were no associations between PVR (P = 0.42), PCWP (P = 0.23), and PAPi (P = 0.45) with procedural success (n = 22). There was also no association between PVR, PCWP, and PAPi and death or heart failure hospitalization (n = 6, Figure 1) over a median 12-day (IQR 4-30) follow-up. [Formula presented] Conclusion: Although a small study, these are the first data since the commercial launch of TTVR in the United States. TTVR appears similarly safe across a range of baseline PVR, PCWP, and PAPi values. More research in larger cohorts is needed to determine if preprocedural right heart catheterization findings can predict clinical outcomes after TTVR. Categories: STRUCTURAL: Valvular Disease: Tricuspid.

Volume

84

Issue

18

First Page

B420

Find It @ Sladen

Share

COinS