Transient acute right coronary artery deformation during transcatheter interventional tricuspid repair with the Cardioband tricuspid system

Background: The Cardioband tricuspid valve reconstruction system is a size-adjustable tricuspid reconstruction device for interventional treatment of tricuspid regurgitation (TR). Contraction of the device after successful implantation can be associated with an acute deformation of the right coronary artery (RCA). Aims: The aim of this study was to provide data on the persistence and clinical significance of acute RCA deformation following Cardioband implant procedures. Methods: Data from all patients with intraprocedural RCA deformation during Cardioband implantation were collected from four centres between October 2018 and January 2020. Control angiographies were performed in all of these patients before discharge. Results: RCA deformation occurred in 14 out of 51 patients. Follow-up coronary angiography showed a complete resolution of deformation in all cases while patients remained clinically asymptomatic and had an uneventful post-interventional course. Intraprocedural coronary stent implantation was performed in two of the earlier cases according to the personal assessment of the implanters. Conclusions: RCA deformation is relatively frequent following interventional tricuspid annuloplasty but appears to be completely reversible in the absence of flow impairment or vascular damage. Based on our early experience watchful waiting is the most appropriate strategy to avoid unnecessary coronary interventions.

Automated summary

This study investigated acute RCA deformation following Cardioband implant procedures and found that deformation was completely reversible in all cases with no clinical symptoms during follow-up. In two early cases, intraprocedural coronary stent implantation was performed based on personal assessment of the implanters. The study suggests that watchful waiting is the most appropriate strategy to avoid unnecessary coronary interventions.