Does Ct-Derived Tricuspid Regurgitationanatomic Regurgitant Orifice Areapredict Symptomatic Improvement after Transcatheter Tricuspid Valve Replacement?

Document Type

Conference Proceeding

Publication Date

7-1-2026

Publication Title

J Cardiovasc Comput Tomogr

Keywords

aged, clinical outcome, cohort analysis, comorbidity, computer assisted tomography, conference abstract, controlled study, female, human, Kansas City Cardiomyopathy Questionnaire, major clinical study, male, retrospective study, surgical risk, tricuspid valve, tricuspid valve disease, tricuspid valve regurgitation, tricuspid valve replacement

Abstract

Introduction: Transcatheter tricuspid valve replacement (TTVR) has emerged as a promising treatment strategy for patients with severe tricuspid regurgitation (TR), particularly in those with high surgical risk or prohibitive comorbidities. Cardiac computed tomography (CT) plays a central role in procedural planning and allows quantitative assessment of TR severity through anatomic regurgitant orifice area (AROA). However, the relationship between CT-derived TR severity and clinical outcomes following TTVR remains poorly defined. We aimed to evaluate whether CT-derived TR AROA predicts symptomatic improvement and mortality following TTVR. Methods: We performed a retrospective single-center analysis of patients undergoing TTVR for severe TR. Pre-procedural TR severity was quantified using CT-derived AROA measurements obtained from dedicated tricuspid valve CT protocols. Clinical outcomes included change in Kansas City Cardiomyopathy Questionnaire (KCCQ) score following TTVR and post-procedural mortality. The association between CT-derived AROA and KCCQ improvement was assessed using Spearman correlation analysis. Logistic regression was used to evaluate the relationship between CT-derived AROA and mortality following TTVR. Results: A total of 110 patients undergoing TTVR were included. CT-derived TR AROA demonstrated a median of 68.8 mm2 (IQR 39.4-152.9 mm2). Improvement in KCCQ score following TTVR was observed in the majority of patients, with a mean increase of 13.8 ± 25.2 points. CT-derived TR AROA demonstrated a modest but statistically significant positive correlation with improvement in KCCQ score (Spearman ρ = 0.25, p = 0.027), suggesting that patients with larger baseline regurgitant orifice areas may derive greater symptomatic benefit following intervention. Post-procedural mortality occurred in 10% of patients. Baseline CT-derived TR EROA was not significantly associated with mortality after TTVR. Conclusions: CT-derived TR AROA demonstrates a modest association with symptomatic improvement following TTVR but does not predict post-procedural mortality. Quantitative CT assessment of TR severity may help identify patients most likely to experience symptomatic benefit after TTVR and further highlights the expanding role of cardiac CT in the evaluation of tricuspid valve disease. [Formula presented]

Volume

20

Issue

4

First Page

S111

Last Page

S112

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