Patients with severe tricuspid regurgitation (TR) have early favorable right atrial (RA) and right ventricular (RV) remodeling after transcatheter tricuspid valve replacement (TTVR), a new study shows. These data were reported by Stamatios Lerakis, MD, PhD, from the Icahn School of Medicine at Mount Sinai, New York, and colleagues, in a manuscript published online in JAMA: Cardiovascular Interventions. TTVR has recently emerged as a treatment option for severe TR instead of surgery or transcatheter edge-to-edge repair (TEER). Patients who had lower baseline functional capacity and impaired RV function had less improvement after TTVR. Former studies have not investigated the impacts of structural remodeling. The investigators in this study examined the impacts of TTVR on right heart remodeling using high-resolution cardiac computed tomography (CCT). A total of 16 patients (median age=79 years, 62% women) with severe TR underwent CCT before and after TTVR between July 2024 and March 2025. The Evoque valve (Edwards Lifesciences) was used in all cases. At baseline and follow-up (median follow-up time of 2.9 months) after TTVR, RV, RV and left ventricular (LV) function were assessed using CCT. RV ejection fraction was significantly reduced from baseline (46.3%) to post-TTVR (36.8%), as well as RV end-diastolic volume index (p=0.04), RV stroke volume (p=0.002) and RA volume (p=0.05). RV end-systolic volume index did not show any significant changes (p=0.53), and neither did LV end-diastolic volume index (p=0.99), LV ejection fraction (EF) (p=0.18) and LV stroke volume (p=0.82), from baseline to post-TTVR. New York Heart Association (NYHA) functional class improvement in all patients following TTVR. At 6-months, one patient died from cardiac arrest, 3 patients were rehospitalized for cardiac reasons and 4 patients received a permanent pacemaker. “These findings complement prior clinical observations of symptomatic improvement and provide new insights into the anatomical mechanisms that may underlie procedural success following TTVR,” the authors concluded. Source: Lerakis S, Mannina C, Ferrandez-Escarabajal M, et al. Right heart remodeling after transcatheter tricuspid valve replacement: An early cardiac CT analysis. JACC Cardiovasc Interv. 2025 September 26 (Article in press). Image Credit: Inga – stock.adobe.com