Hemodynamic Changes Related To Computed Tomography Annulus Sizing In Tricuspid Valve Transcatheter Edge-to-edge Repair
Recommended Citation
Fram G, Dawdy J, Saleem M, Alrayes H, Kar Lok Lai L, Mohammed M, Obeidat L, Alter J, Lai K, Engel Gonzalez P, Villablanca P, Frisoli T, O'Neill BP, Parikh S, Zweig B, Lee JC. Hemodynamic Changes Related To Computed Tomography Annulus Sizing In Tricuspid Valve Transcatheter Edge-to-edge Repair. J Cardiovasc Comput Tomogr 2025; 19(4):S94-S95.
Document Type
Conference Proceeding
Publication Date
7-1-2025
Publication Title
J Cardiovasc Comput Tomogr
Abstract
Introduction: Tricuspid valve (TV) edge-to-edge repair (TEER) is a novel procedure to treat patients with severe tricuspid regurgitation (TR). Although commercially available, there is a lack of data predicting hemodynamic consequences with deployment of tricuspid TEER clasp devices. Utilizing gated cardiac computed tomography (CCT) for procedural planning may offer benefit. Methods: Retrospective analysis was conducted on twenty patients who underwent TV-TEER between August 2024 and February 2025, with the TriClip (Abbott, USA) device. All patients had pre-procedural imaging with CCT analysis and echocardiogram. Each patient underwent post-procedural transthoracic echocardiogram within 24 hours after TV-TEER. Results: Illustrated in figure 1A is the rise in trans-tricuspid gradient per clip, by baseline CCT-derived annular area. The average rise in gradient in the entire cohort (n=20) was 1.6 mmHg per patient, and 0.8 mmHg per clip. However, the average gradient rise per clip deployed in those patients with an annulus < 1,600 mm2 (n=6) was 1.7 mmHg, while in those patients with an annulus > 1,600 mm2 (n=14) the average gradient rise per clip deployed was 0.5 mmHg. Detailed outcomes of each patient are demonstrated in figure 1B. Conclusions: In our single center experience, patients with CCT-derived tricuspid annular area less than 1,600 mm2 on pre-procedural imaging appeared to demonstrate a more significant rise in TV diastolic gradients per clip deployed during TV-TEER. Pre-procedural CCT is of paramount importance in patients undergoing TV-TEER and aids procedural planning and predicting hemodynamic outcomes. To our knowledge, this is the earliest commercial descriptive data demonstrating the relationship between CCT-derived TV annuli and hemodynamic outcomes. Larger studies are needed to determine further impact, as well as a direct relationship between pre-procedural annular size and post-procedural change in TV diastolic gradients, as our data suggests. [Formula presented]
Volume
19
Issue
4
First Page
S94
Last Page
S95
