Key result
MitraClip edge-to-edge repair provides a feasible alternative for severe functional tricuspid regurgitation in inoperable patients.
Why the study?
Severe functional tricuspid regurgitation in frail patients with prior sternotomy poses challenges for open repair, motivating evaluation of percutaneous edge-to-edge repair.
Case Report (n=1)
No
An 80-year-old man with recurrent right heart failure despite optimal heart failure therapy, was referred to our institution. He had inferior myocardial infarction, had undergone a coronary artery bypass graft operation and had a permanent pacemaker. Echocardiography showed a dilated right ventricle with impaired systolic function (Tricuspid annular plane systolic excursion (TAPSE) 10 mm), a dilated tricuspid annulus (septal-lateral diameter 4 cm) and massive (4+) functional tricuspid regurgitation (TR) (figure 1A). The tricuspid valve (TV) was structurally intact without impingement or perforation by the pacemaker lead (figure 2A,B). The heart team did not consider him fit for open repair because of the previous sternotomy and his frailty (score 6/9),1 and recommended percutaneous edge-to-edge TV repair with the MitraClip device. Figure 1 (A) Colour flow Doppler of tricuspid valve (TV) from the apical four-chamber view: massive tricuspid regurgitation (TR) with an effective regurgitation orifice (ERO) was 0.35 cm2 …
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Cheung et al. (2018) conducted a case report in Severe tricuspid regurgitation and recurrent right heart failure (n=1). Percutaneous edge-to-edge tricuspid valve repair with the MitraClip device was evaluated. Percutaneous edge-to-edge tricuspid valve repair with the MitraClip device was recommended for an 80-year-old man with severe functional tricuspid regurgitation unfit for open surgery.