DISCUSSION
The findings of this study, the first to evaluate RV remodeling after TMVI in patients excluded from conventional cardiac surgery due to excessive risk, can be summarized as follows: TMVI using the transapically tethered Tendyne mitral valve system resulted in (i) abolition of MR with an associated immediate increase in SVI and a reduction in LV volumes; (ii) an immediate increase in RVSWI with an improvement in RV contractile performance as measured by RVFAC, TAPSE, RVFWLS and RVS’; (iii) a reduction in PASP and severity of TR at 3-months. The extent of improvement in RV remodeling at 3-months in the group with severe LV dysfunction was similar to that of the group with less severe LV and RV dysfunction at baseline (Figure 6; Video 1 and 2).