TCT-981 Cardiogenic Shock Following Transcatheter Tricuspid Valve Replacement: A Single Center Experience

Document Type

Conference Proceeding

Publication Date

10-28-2025

Publication Title

J Am Coll Cardiol

Abstract

Background: The potential for acute-on-chronic RV failure remains unclear following valve implantation. In this study, we describe the incidence of cardiogenic shock after TTVR. Methods: This is a retrospective analysis of 122 patients who underwent TTVR for severe TR at Henry Ford Hospital between March 2024 and April 2025. Clinical courses were reviewed to identify cases of hemodynamic compromise meeting SCAI Stage C shock criteria within 24 hours post-procedure. RV dysfunction was assessed by visual estimation and graded on a four-point scale: none, mild, moderate, and severe. Results: Of the 122 patients, 3 (2.45%) developed SCAI Stage C cardiogenic shock within 24 hours of the procedure. At baseline, 28 patients (22.9%) had ≥moderate RV dysfunction. The incidence of post-procedural shock was numerically higher among patients with ≥moderate RV dysfunction (7.14%) compared to those ≤mild RV dysfunction (1.06%), although this difference did not reach statistical significance (RR 6.71; 95% CI: 0.64–70.5; p=0.150). All three patients demonstrated rapid clinical improvement following volume optimization and achieved hemodynamic stability within 12-hours. Notably, none progressed to SCAI Stage D shock and all patients avoided in-patient and 3-month mortality. [Formula presented] Conclusion: The incidence of cardiogenic shock following TTVR is low, even among patients with advanced RV dysfunction. In cases of acute heart failure, rapid clinical improvement with volume optimization was observed. These findings support thoughtful cardiac prehabilitation and support the overall safety of TTVR in patients with advanced RV dysfunction. Categories: STRUCTURAL: Valvular Disease and Intervention: Tricuspid

Volume

86

Issue

17

First Page

B419

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