Author + information
- Received February 11, 2019
- Revision received April 10, 2019
- Accepted April 11, 2019
- Published online August 5, 2019.
- Nicole Karam, MD, PhDa,b,
- Daniel Braun, MDa,
- Michael Mehr, MDa,c,
- Mathias Orban, MDa,c,
- Thomas J. Stocker, MDa,c,
- Simon Deseive, MDa,c,
- Martin Orban, MDa,c,
- Christian Hagl, MDc,d,
- Michael Näbauer, MDa,
- Steffen Massberg, MDa,c and
- Jörg Hausleiter, MDa,c,∗ (, )@nickaram
- aMedizinische Klinik und Poliklinik I, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany
- bEuropean Hospital Georges Pompidou (Cardiology Department) and Paris Cardiovascular Research Center (INSERMU970), Paris, France
- cMunich Heart Alliance, Partner Site German Center for Cardiovascular Disease (DZHK), Munich, Germany
- dHerzchirurgische Klinik und Poliklinik, Klinikum der Universität München, Munich, Germany
- ↵∗Address for correspondence:
Prof. Jörg Hausleiter, Medizinische Klinik I, Ludwig-Maximilians-Universität München, Marchioninistraße 15, Munich 81377, Germany.
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 < 0.001). Among patients with abnormal baseline liver function, significant reductions in aspartate transaminase (50.5 U/l to 39.9 U/l; p = 0.02) and bilirubin (1.8 mg/dl to 1.5 mg/dl; p = 0.03) were also observed.
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.
Dr. Karam has received consultant fees from Abbott Vascular. Dr. Braun has received speaker honoraria from Abbott Vascular. Dr. Mehr has received travel grants from Bristol-Myers Squibb. Dr. Näbauer has received speaker honoraria from Abbott Vascular and Edwards Lifesciences. Prof. Hausleiter has received research support and speaker honoraria from Abbott Vascular and Edwards Lifesciences. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received February 11, 2019.
- Revision received April 10, 2019.
- Accepted April 11, 2019.
- 2019 American College of Cardiology Foundation
This article requires a subscription or purchase to view the full text. If you are a subscriber or member, click Login or the Subscribe link (top menu above) to access this article.