Author + information
- Received August 22, 2018
- Revision received September 25, 2018
- Accepted September 27, 2018
- Published online March 4, 2019.
- Francesco F. Faletra, MDa,∗ (, )
- Giovanni Pedrazzini, MDa,
- Michel Züber, MDb,
- Laura Anna Leo, MDa,
- Vera Paiocchi, MDa,
- Francesco Maisano, MDb,
- Paolo Denti, MDc and
- Tiziano Moccetti, MDa
- aDepartment of Cardiology, Fondazione Cardiocentro Ticino, Lugano, Switzerland
- bDepartment of Cardiology, University Heart Center, Zurich, Switzerland
- cDepartment of Cardiac Surgery, Istituto Scientifico S. Raffaele, Milan, Italy
- ↵∗Address for correspondence:
Dr. Francesco F. Faletra, Division of Cardiology, Fondazione Cardiocentro Ticino, Via Tesserete 48, CH-6900 Lugano, Switzerland.
In high-risk patients with symptomatic severe functional tricuspid regurgitation (FTR) transcatheter intervention using a mitral clip system is a possible alternative to surgical treatment. Transesophageal echocardiographic (TEE) is essential for the success of the procedure when using a mitral clip. However, in transcatheter clipping of FTR, 2-dimensional and/or 3-dimensional TEE views are not yet well established. Although other standardized and off-axis views may be equally effective in guiding transcatheter clipping of FTR, in our initial experience (n = 5), we found that transgastric short axis and the corresponding perpendicular long axis of the right ventricle were useful 2-dimensional and/or 3-dimensional TEE views for guiding the procedure. In this imaging vignette, we present the last 2 patients (Figures 1, 2, 3, 4, 5, and 6⇓⇓⇓⇓⇓⇓, Videos 1, 2, 3, 4, 5, 6, 7, 8, 9, 10, and 11) who had the procedure mainly guided by using transgastric views.
Short-axis transgastric view allows delineation of the morphology of the leaflets, the regurgitant orifice, and the position of the arms perpendicularly to the line of coaptation. The corresponding perpendicular long-axis view obtained in X-plane modality allows definition of the position of the clip delivery system across the valve.
Dr. Faletra has received speaker honorarium from Philips. Dr. Maisano has been a consultant for Abbott Vascular, Medtronic, and Edwards. Dr. Denti has been a consultant for 4Tech; and has received speaker honorarium from Abbott. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received August 22, 2018.
- Revision received September 25, 2018.
- Accepted September 27, 2018.
- 2019 American College of Cardiology Foundation