Key result
Transgastric TEE imaging improves tricuspid valve morphology visualization and avoids shadowing artifacts during TEER.
Why the study?
Intraprocedural TEE guidance for transcatheter edge-to-edge repair of the tricuspid valve faces challenges due to morphological complexity and imaging restrictions.
Transgastric acoustic windows are proposed as a key measure for successful periprocedural TEE guidance during tricuspid TEER to overcome morphological complexity and shadowing artifacts.
May facilitate TEE guidance during tricuspid edge-to-edge repair; leaves open whether it improves outcomes in prospective studies.
Intraprocedural transesophageal echocardiography (TEE) guidance plays an essential role in transcatheter repair therapy of the tricuspid valve (TV). So far, several different imaging concepts are in use. We propose an imaging protocol that fully addresses the morphological complexity of the TV and further offers efficacious workarounds for the frequently occurring restrictions of TV imaging in edge-to-edge repair of the TV. As a tertiary referral center with a large experience of more than 250 cases of transcatheter edge-to-edge repair (TEER) of the TV performed at the Heart Valve Center in Mainz/Germany, we have constantly adapted our peri-interventional echocardiographic approach to accomplish both. As a key measure for success, we intensely rely on the transgastric acoustic windows that not only deliver high-resolution information on the morphology of the TV and all relevant procedural steps but also help to avoid the frequent shadowing artifacts experienced in transesophageal imaging.
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Silva et al. (2021) studied Tricuspid valve disease undergoing transcatheter edge-to-edge repair (n=250). Transgastric imaging protocol for TEE guidance was evaluated. Transgastric imaging during transesophageal echocardiography guidance for tricuspid valve edge-to-edge repair provides high-resolution morphology and avoids shadowing artifacts.
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