Tricuspid transcatheter edge-to-edge repair was complicated by iatrogenic posterior leaflet perforation, highlighting the critical role of intraprocedural echocardiographic guidance.
Case Report (n=1)
This case highlights iatrogenic leaflet perforation as a serious complication of tricuspid TEER and emphasizes the critical role of real-time intraprocedural echocardiographic guidance.
BACKGROUND: Transcatheter edge-to-edge repair (TEER) has emerged as an effective minimally invasive treatment for severe tricuspid regurgitation (TR). CASE SUMMARY: A 68-year-old man known to have ischemic cardiomyopathy, atrial fibrillation, and severe TR presented with right heart failure requiring ascitic drainage. After heart team discussion, he was admitted for elective TEER. The procedure was performed under general anesthesia using the TriClip XTW system. During deployment of a second clip, transesophageal echocardiography revealed an iatrogenic perforation of the posterior leaflet. The clip was withdrawn, however attempts to plug the perforation were unsuccessful, resulting in severe residual TR. DISCUSSION: This case illustrates a serious complication of tricuspid TEER: iatrogenic leaflet perforation. It highlights the role of intraprocedural imaging in real-time complication recognition and decision-making. TAKE-HOME MESSAGES: Iatrogenic leaflet perforation is a critical risk during tricuspid TEER. Echocardiographic guidance is paramount for steering and immediate identification of procedural complications.
Almarshud et al. (Mon,) conducted a case report in Severe tricuspid regurgitation (n=1). Tricuspid transcatheter edge-to-edge repair (TEER) was evaluated. Tricuspid transcatheter edge-to-edge repair was complicated by iatrogenic posterior leaflet perforation, highlighting the critical role of intraprocedural echocardiographic guidance.
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