Transcatheter Intervention Is Associated With Visceral Decongestion in Patients With Severe Tricuspid Regurgitation.
5 affiliations
- 1Department of Nephrology, University Hospital Regensburg, Regensburg, Germany.
- 2Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany.
- 3Department of Cardiology, Krankenhaus Barmherzige Brüder, Regensburg, Germany.
- 4Department of Internal Medicine I, Klinikum St. Marien, Amberg, Germany.
- 5Department of Internal Medicine I, University Hospital Gießen and Marburg, Marburg, Germany.
Abstract
Introduction
Tricuspid regurgitation (TR) is frequently associated with severe venous congestion, increasingly recognized as a key factor in the development of cardiorenal syndrome. While transcatheter tricuspid valve intervention (TTVI) has shown to be effective in TR reduction, their impact on visceral venous congestion remains unknown. The aim of our study was to investigate visceral venous congestion in patients with severe TR undergoing TTVI.Methods
We prospectively enrolled 30 patients undergoing TTVI for severe TR. Renal venous blood flow was assessed by Doppler ultrasound examination at baseline and 1 to 3 months after the procedure. A 5-grade rating scale was developed to categorize venous flow from continuous (Grade I°) through discontinuous to a pendulous venous flow (Grade V°) within the kidneys.Results
Transcatheter edge-to-edge repair (TEER, n = 24) was performed in 24 patients; 6 patients underwent heterotopic caval valve implantation. At baseline, severe renal congestion was present in most participants, with 20 patients showing venous flow profiles IV or V. Venous flow profiles strongly correlated with invasively measured right atrial mean pressure and V wave (p < 0.01). At follow-up, venous renal blood flow profiles improved significantly (p = 0.003), reducing patients with profiles IV or V from 20 to 9. Portal vein flow showed comparable decongestive changes. In TEER patients, reduction of TR ≥ 2 grades was associated with improved renal vein profile at follow-up (p = 0.002).Conclusion
Successful TTVI leads to visceral decongestion. Renal venous flow currently represents a physiological marker of congestion that may complement conventional echocardiographic parameters; its role in guiding patient selection or timing of intervention remains to be determined in larger studies.
Related
- Coexisting Moderate-to-Severe Tricuspid Regurgitation and Renal Dysfunction Identify a High-Risk Group After Transcatheter Aortic Valve Replacement
- Impact of Tricuspid Regurgitation on Outcomes After Transcatheter Edge-to-Edge Repair for Primary Mitral Regurgitation: The PRIME-MR Registry
- Sex differences and gender-related disparities in transcatheter tricuspid edge-to-edge repair for secondary tricuspid regurgitation: toward a personalized approach in cardiac care
- Robotic tricuspid valve repair for infective endocarditis with leaflet perforation and severe tricuspid regurgitation
- Phenotypes of Secondary Tricuspid Regurgitation
BibTeX
@article{putz2026transcatheter,
title = {{Transcatheter Intervention Is Associated With Visceral Decongestion in Patients With Severe Tricuspid Regurgitation.}},
author = {Franz Josef Putz and Johannes Spahn and Paul C Kranert and Franziska Grewe and Moritz Haus and Michael Wester and Valeska Bienert and Maximilian Trum and Christian Schach and Andreas Luchner and Christoph Birner and Bernhard Unsöld and Miriam C Banas and Bernhard Banas and Lars S Maier and Kurt Debl and Michael Paulus and Christine Meindl},
journal = {Clinical cardiology},
year = {2026},
month = oct,
doi = {10.1002/clc.70497},
url = {https://europepmc.org/article/MED/42910496},
note = {CC BY},
}
RIS
TY - JOUR
TI - Transcatheter Intervention Is Associated With Visceral Decongestion in Patients With Severe Tricuspid Regurgitation.
AU - Franz Josef Putz
AU - Johannes Spahn
AU - Paul C Kranert
AU - Franziska Grewe
AU - Moritz Haus
AU - Michael Wester
AU - Valeska Bienert
AU - Maximilian Trum
AU - Christian Schach
AU - Andreas Luchner
AU - Christoph Birner
AU - Bernhard Unsöld
AU - Miriam C Banas
AU - Bernhard Banas
AU - Lars S Maier
AU - Kurt Debl
AU - Michael Paulus
AU - Christine Meindl
PY - 2026
DA - 2026/10/01
JO - Clinical cardiology
DO - 10.1002/clc.70497
UR - https://europepmc.org/article/MED/42910496
AB - Introduction Tricuspid regurgitation (TR) is frequently associated with severe venous congestion, increasingly recognized as a key factor in the development of cardiorenal syndrome. While transcatheter tricuspid valve intervention (TTVI) has shown to be effective in TR reduction, their impact on visceral venous congestion remains unknown. The aim of our study was to investigate visceral venous congestion in patients with severe TR undergoing TTVI.Methods We prospectively enrolled 30 patients undergoing TTVI for severe TR. Renal venous blood flow was assessed by Doppler ultrasound examination at baseline and 1 to 3 months after the procedure. A 5-grade rating scale was developed to categorize venous flow from continuous (Grade I°) through discontinuous to a pendulous venous flow (Grade V°) within the kidneys.Results Transcatheter edge-to-edge repair (TEER, n = 24) was performed in 24 patients; 6 patients underwent heterotopic caval valve implantation. At baseline, severe renal congestion was present in most participants, with 20 patients showing venous flow profiles IV or V. Venous flow profiles strongly correlated with invasively measured right atrial mean pressure and V wave (p < 0.01). At follow-up, venous renal blood flow profiles improved significantly (p = 0.003), reducing patients with profiles IV or V from 20 to 9. Portal vein flow showed comparable decongestive changes. In TEER patients, reduction of TR ≥ 2 grades was associated with improved renal vein profile at follow-up (p = 0.002).Conclusion Successful TTVI leads to visceral decongestion. Renal venous flow currently represents a physiological marker of congestion that may complement conventional echocardiographic parameters; its role in guiding patient selection or timing of intervention remains to be determined in larger studies.
SN - 0160-9289
SN - 1932-8737
ER -