Key result
Transjugular T-TEER achieves successful tricuspid regurgitation reduction to mild severity without access-site complications.
Why the study?
Hostile inferior vena cava anatomy may preclude safe transfemoral access for tricuspid transcatheter edge-to-edge repair, necessitating alternative approaches.
Does transjugular tricuspid transcatheter edge-to-edge repair safely reduce tricuspid regurgitation in patients with hostile inferior vena cava anatomy?
Case Report (n=1)
Does transjugular tricuspid transcatheter edge-to-edge repair safely reduce tricuspid regurgitation in patients with hostile inferior vena cava anatomy?
Transjugular T-TEER is a technically feasible and safe alternative strategy for patients with severe tricuspid regurgitation when standard transfemoral delivery is precluded by hostile inferior vena cava anatomy.
Transjugular T-TEER may be feasible when transfemoral access is precluded; leaves open need for prospective data before clinical adoption.
OBJECTIVE: To describe a step-by-step transjugular approach for tricuspid transcatheter edge-to-edge repair (T-TEER) when hostile inferior vena cava anatomy precludes safe transfemoral access. KEY STEPS: We describe a case transjugular T-TEER in a patient with severe tricuspid regurgitation and prohibitive inferior vena cava anatomy. Distal right jugular access was obtained under ultrasound guidance with preclosure. Progressive dilation allowed advancement of the guiding catheter over stiff guidewire. Navigation toward tricuspid valve required awareness of reversed catheter movements to maintain orientation. Two devices were implanted in the anteroseptal position under echocardiographic guidance, using the first clip as landmark for the second one. The system was straightened before withdrawal. POTENTIAL PITFALLS: Large-bore jugular access may increase risk of vascular complications; distal puncture and gradual dilation are essential. Reversed catheter movements may cause disorientation or interaction with atrial structures. TAKE-HOME MESSAGE: Transjugular access represents a feasible alternative for T-TEER when transfemoral delivery is unsafe.
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Secco et al. (2026) conducted a case report in Severe tricuspid regurgitation with hostile inferior vena cava anatomy (n=1). Transjugular tricuspid transcatheter edge-to-edge repair (T-TEER) was evaluated on Procedural feasibility and safety (reduction of TR, absence of access-site complications). Transjugular tricuspid transcatheter edge-to-edge repair was successfully performed, resulting in mild residual tricuspid regurgitation without access-site complications.
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