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Minerva Cardiology and Angiology 2021 Sep 02

DOI: 10.23736/S2724-5683.21.05697-0

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Imaging for transcatheter native tricuspid valve intervention: patient selection, procedural planning and interventional guidance

Edwin C. HO , Azeem LATIB

Division of Cardiology, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, NY, USA


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There are an increasing number of transcatheter tricuspid valve interventions being performed worldwide using commercially available and investigational devices. These devices can be classified by their intended mechanism of correction of tricuspid valve disease and imaging in the pre-procedural and periprocedural period is essential for procedural and clinical success. This review summarizes the current devices in use and how imaging is used for patient selection, procedural planning and interventional guidance. The most commonly used method of transcatheter tricuspid intervention is edge-to-edge repair using the MitraClip or TriClip devices (Abbott, Santa Clara, CA , USA). Randomized controlled data is pending but observational studies have demonstrated success, especially in the setting of smaller coaptation gaps and adequate transesophageal imaging windows. Direct annuloplasty with the Cardioband (Edwards Lifesciences, Irvine, CA, USA) has also been used in many centers and has demonstrated success when the anatomy and mechanism of tricuspid regurgitation based on imaging methods are appropriate for annuloplasty. Lastly, transcatheter valve replacement is becoming more common using several investigational devices and relies heavily on imaging methods to achieve procedural and clinical success. Multimodality imaging plays a crucial role in patient selection and procedural planning for transcatheter tricuspid valve repair or replacement. Echocardiographic based techniques are particularly important in these procedures, especially for interventional guidance.


KEY WORDS: Tricuspid regurgitation; Transcatheter repair; Transcatheter replacement; Interventional echocardiography; Echocardiography

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