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Impact of Transcatheter Tricuspid Valve Repair for Severe Tricuspid Regurgitation on Kidney and Liver Function

Authors :
Michael Nabauer
Mathias Orban
Thomas J. Stocker
Christian Hagl
Nicole Karam
Michael Mehr
Martin Orban
Jörg Hausleiter
Daniel Braun
Steffen Massberg
Simon Deseive
Source :
JACC: Cardiovascular Interventions. 12:1413-1420
Publication Year :
2019
Publisher :
Elsevier BV, 2019.

Abstract

Objectives This study sought to determine the impact of transcatheter tricuspid edge-to-edge valve repair (TTVR) of severe tricuspid regurgitation (TR) on kidney and liver functions. Background TR leads to impairment in renal and hepatic function, which is associated with worse prognosis. TTVR emerged as a treatment option for patients ineligible for cardiac surgery. However, no study has assessed the impact of TTVR on kidney and liver functions. Methods All patients treated with TTVR in our center between March 2016 and June 2018 were included. Kidney and liver functions were compared at baseline, 30 days, and 6 months. Results Over the study period, 126 patients were treated for TR (59 isolated TTVR and 67 TMTVR). Among them, 110 (87.3%) survived at 6 months. Among survivors, renal function remained stable, including among patients with moderate-to-severe chronic kidney disease (mean glomerular filtration rate 37.5 ml/min/1.73 m2 at baseline vs. 40.1 ml/min/1.73 m2 at 6 months; p = 0.39). Regarding liver function, a significant improvement at 6 months was only observed in the alanine transaminase level in the entire cohort (30.7 U/l vs. 24.9 U/l; p Conclusions TR reduction by TTVR is associated with an improvement in liver function, mainly among patients with abnormal liver function at baseline, whereas kidney function remained stable. Accordingly, TTVR is an attractive option especially for patients presenting with severe TR and liver dysfunctions, who are at even higher surgical risk compared with patients who still have normal organ functions.

Details

ISSN :
19368798
Volume :
12
Database :
OpenAIRE
Journal :
JACC: Cardiovascular Interventions
Accession number :
edsair.doi.dedup.....1899ab5154f6746c7b55c96d419fd537