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Kidney and Liver Function After Transcatheter Tricuspid Repair
Study Questions:
What is the impact of transcatheter tricuspid edge-to-edge valve repair (TTVR) of severe tricuspid regurgitation (TR) on kidney and liver functions?
Methods:
The investigators analyzed all patients treated with TTVR in their center between March 2016 and June 2018. Kidney and liver functions were compared at baseline, 30 days, and 6 months. Mean baseline, 30-day, and 6-month values were compared in the global population using the chi-square test, paired Student’s t-test, or Wilcoxon test, as appropriate.
Results:
Over the study period, 126 patients were treated for TR (59 isolated TTVR and 67 transcatheter mitral and tricuspid valve repair [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 (50.5-39.9 U/L; p = 0.02) and bilirubin (1.8-1.5 mg/dl; p = 0.03) were also observed.
Conclusions:
The authors concluded that 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.
Perspective:
This single-center registry study reports that TR reduction by TTVR is associated with an improvement in liver function, primarily among patients with abnormal liver function at baseline, whereas kidney function remained stable. It appears that TTVR may be an attractive option for patients presenting with severe TR and kidney or liver dysfunctions, who are at even higher surgical risks compared with patients who have normal kidney and liver functions. Additional larger studies with longer follow-up are needed to assess the impact of kidney and liver function improvement on patients’ prognosis and hard outcomes.
Clinical Topics: Geriatric Cardiology, Prevention, Valvular Heart Disease, Statins
Keywords: Alanine Transaminase, Aspartate Aminotransferases, Bilirubin, Cardiology Interventions, Geriatrics, Glomerular Filtration Rate, Heart Valve Diseases, Kidney Diseases, Liver Diseases, Renal Insufficiency, Chronic, Secondary Prevention, Tricuspid Valve Insufficiency
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