CONCLUSIONS:
RV systolic dysfunction is a frequent finding in patients referred for mitral valve surgery and is both a direct and indirect consequence of LV volume overload. Tendyne TMVI resulted in an immediate improvement in RV function, most likely due to abolition of MR with an associated reduction in LV volumes and reduction in PASP. The preservation of circumferential and radial strain despite an abrupt reduction in LV volume loading, raises the possibility that the apical tether redistributes LV contractile forces and enhances the interventricular septal contribution to RV function. Further longitudinal studies of larger cohorts are needed to confirm and extend our results.