Persistent Hypoxia After Tricuspid Valve Replacement.

Figures

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  Figure 1. TTE After Noted Platypnea-Orthodeoxia, Subcostal View With Color Doppler Showing Interatrial Flow (Red Arrow) LA = left atrium; RA = right atrium; TTE = transthoracic echocardiography.

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  Figure 2. TTE After Noted Platypnea-Orthodeoxia, Apical 4-Chamber View With Bubble Study Positive for Interatrial Shunt (Left Atrial Agitated Saline Contrast Within 3 Cardiac Cycles) With Quiet Respiration and Valsalva LA = left atrium; RA = right atrium; TTE = transthoracic echocardiography.

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  Figure 3. Pre-TTVR Screening TEE Midesophageal Bicaval View Showing PFO (Red Arrow) LA = left atrium; PFO = patent foramen ovale; RA = right atrium; TEE = transesophageal echocardiography; TTVR = transcatheter tricuspid valve replacement.

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  Figure 4. Intraoperative TEE During TTVR, Midesophageal Bicaval View Again Showing PFO (Red Arrow) Abbreviations as in Figure 3.

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  Figure 5. Intraoperative TEE During TTVR, Midesophageal Short-Axis View Color Compare Showing PFO (Red Arrow) and Right-to-left Shunt on Color Doppler (Blue Arrow) Abbreviations as in Figure 3.

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  Figure 6. Intraoperative TEE During TTVR, Midesophageal Short-Axis View With Bubble Study Showing PFO (Red Arrow) and Right-to-Left Shunting Within 3 Cardiac Cycles Abbreviations as in Figure 3.

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  Figure 7. PFO Closure Device Placement (Red Arrow) With TTVR Valve (Blue Arrow) and Coronary Sinus Pacemaker Leads Present (Yellow Arrow) PFO = patent foramen ovale; TTVR = transcatheter tricuspid valve replacement.

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  Figure 8. Intraoperative TEE After PFO Closure Device Placement (Red Arrow), Midesophageal Short-Axis View With Minimal Residual Shunt LA = left atrium; PFO = patent foramen ovale; RA = right atrium; TEE = transesophageal echocardiography.

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  Figure 9. Repeat TTE After PFO Closure Device Placement (Red Arrows), Subcostal View Showing No Residual Interatrial Shunting on Color Doppler TTE = transthoracic echocardiography; remaining abbreviations as in Figure 8.