Successful transcatheter tricuspid valve intervention leads to visceral decongestion, with renal and portal venous flow profiles improving significantly 1 to 3 months after the procedure in patients with severe TR.
Most patients with severe tricuspid regurgitation undergoing TTVI had severe renal venous congestion at baseline.
Renal venous flow profiles correlated strongly with invasively measured right-sided pressures.
Renal venous flow profiles improved significantly after TTVI.
Portal vein flow showed decongestive changes comparable to those in the renal veins after TTVI.
In TEER patients, reducing TR by 2 or more grades was associated with improved renal vein flow profile.
The cohort included two types of tricuspid intervention: TEER and heterotopic caval valve implantation.
The authors conclude that renal venous flow may complement echocardiographic parameters as a congestion marker, but its role in patient selection or timing of intervention is not yet established.
Leaky tricuspid valves allow blood to flow backward and can cause pressure to build up in the veins, which may harm organs like the kidneys and liver. This study asked whether procedures that fix the valve through a catheter (without open-heart surgery) also relieve this congestion in the abdominal organs. The researchers followed 30 patients with severe tricuspid regurgitation, using ultrasound to look at blood flow in the kidney veins and the portal vein of the liver before and 1 to 3 months after the procedure. Before treatment, most patients showed signs of severe congestion: 20 of 30 had the two worst flow patterns in their kidney veins. These patterns matched pressure measurements taken directly inside the heart. After the procedure, kidney vein flow improved significantly, and the number of patients with the worst patterns fell from 20 to 9. Portal vein flow improved similarly. Among patients treated by edge-to-edge repair, those whose valve leak was reduced by at least two grades were more likely to show improved kidney vein flow. This research suggests that successful catheter-based tricuspid treatment can relieve congestion in the organs, and that a simple ultrasound of kidney vein flow might become a useful marker of congestion alongside standard heart ultrasound. However, the study was small, and it is not yet known whether using this measure can help decide who should be treated or when. Larger studies are needed.
Putz F, Spahn J, Kranert P, Grewe F, Haus M, Wester M, et al.. (2026). Transcatheter Intervention Is Associated With Visceral Decongestion in Patients With Severe Tricuspid Regurgitation.. Clinical cardiology. https://doi.org/10.1002/clc.70497