Right Ventricular Function and Afterload Following Novel Transcatheter Tricuspid Valve Replacement

Right ventricular (RV) function is an important determinant of prognosis in pulmonary hypertension and valvular heart disease. The accurate assessment of RV function is however limited by the presence of concomitant tricuspid regurgitation (TR). Implantation of a novel transcatheter tricuspid valve device in this case highlights the importance of recognizing these limitations, and the need to define alternative ways to measure RV systolic function, contextualized to pulmonary pressure in patients with severe TR. It also demonstrates the clinical potential of perforation of the pop-off zone in this prosthesis, to create mild residual TR, thereby reducing the increase in RV afterload of this intervention, and its impact on RV systolic function.