Author + information
- Received March 21, 2016
- Revision received October 4, 2016
- Accepted October 7, 2016
- Published online March 15, 2017.
- Eustachio Agricola, MDa,∗ (, )
- Francesco Ancona, MDa,
- Stefano Stella, MDa,
- Isabella Rosa, MDa,
- Claudia Marini, MDa,
- Marco Spartera, MDa,
- Paolo Denti, MDb,
- Alberto Margonato, MDa,
- Rebecca T. Hahn, MDc,
- Ottavio Alfieri, MDb,
- Antonio Colombo, MDd and
- Azeem Latib, MDd
- aEchocardiography Laboratory, San Raffaele Scientific Institute, Milan, Italy
- bCardiac Surgery Department, San Raffaele Scientific Institute, Milan, Italy
- cColumbia University Medical Center/New York Presbyterian Hospital, New York, New York
- dDepartment of Interventional Cardiology, San Raffaele Scientific Institute, Milan, Italy
- ↵∗Reprint requests and correspondence:
Dr. Eustachio Agricola, Director of Echocardiography Laboratory, San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milano, Italy.
Percutaneous tricuspid valve (TV) repair procedures are emerging therapies for patients with symptomatic severe tricuspid regurgitation (TR) who are deemed inoperable. Some of these procedures target the tricuspid annulus (TA), mimicking the Kay procedure, or the leaflets, mimicking Alfieri stitch repair. These procedures need to be performed under direct imaging guidance, usually using echocardiography and fluoroscopy. Accurate knowledge of the anatomic and functional imaging of the TV apparatus (Figure 1), the devices, and the procedural steps is crucial for the success of these procedures. An intraprocedural multimodality imaging approach (2-dimensional [2D] and 3-dimensional [3D] transesophageal echocardiography [TEE]), fluoroscopy, angiography, and intracardiac echocardiography (ICE) are used during percutaneous TV repair.
This study aims to provide a practical guide for echocardiographic monitoring during percutaneous TV repair procedures by reporting our initial experience with 3 different devices (Figures 2 to 5⇓⇓⇓⇓) using 2D and 3D echocardiographic guidance.
Dr. Latib has served as a consultant for Mitralign, Millipede, and 4-Tech; and has received honoraria from Abbott Vascular. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received March 21, 2016.
- Revision received October 4, 2016.
- Accepted October 7, 2016.
- 2017 American College of Cardiology Foundation