Tricuspid transcatheter edge-to-edge repair in local anaesthesia guided by three-dimensional intracardiac echocardiography: a case report

Figures

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  Figure 1. Procedural images by intracardiac echocardiography and conventional fluoroscopy. Legend: Panel A): preprocedural biplane imaging with colour doppler showing severe tricuspid regurgitation; Panel B): periprocedural multiplanar reconstruction of residual tricuspid regurgitation after implantation of the first device; Panel C) and D): fluoroscopic imaging describing the anatomical relationship between both devices in en-face [Panel C)] and right anterior oblique view [Panel D)], *: tricuspid transcatheter edge-to-edge repair device, arrow: device delivery system, §: three-dimensional intracardiac echocardiography probe; Panel E): biplane imaging with colour doppler demonstrating the final result with mild residual tricuspid regurgitation after implantation of two devices.

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  Figure 2. Potential transfemoral setups for single operator intracardiac echocardiography-only guided transcatheter tricuspid edge-to-edge repair. Legend: Panel A) shows a setup with cranial introduction of the fluoroscopic C-arm, while panel B) describes a setup with left-sided introduction; C: fluoroscopic C-arm, E: echocardiography machine, I: interventionalist, who is manoeuvring the probe and performing T-TEER, IS: imaging specialist, who is processing the delivered imaging by creating 3D multi-planar reconstructions and following the device accordingly, PS: projection screen.