Intracardiac echocardiography guidance during tricuspid edge-to-edge repair yielded similar tricuspid regurgitation reduction compared to TEE alone (2.1 vs 1.9 grade reduction, P=0.28).
Observational (n=42)
Does intracardiac echocardiography (ICE) improve leaflet visualization and procedural outcomes compared to TEE alone in patients undergoing transcatheter edge-to-edge tricuspid valve repair?
Intracardiac echocardiography is a useful adjunct to transesophageal echocardiography during transcatheter edge-to-edge tricuspid valve repair, facilitating superior leaflet visualization with comparable procedural success.
Absolute Event Rate: 2.1% vs 1.9%
p-value: p=0.28
Background: Tricuspid edge to edge repair (TEER) is a novel treatment for severe tricuspid regurgitation and is highly dependent on intraprocedural image quality. To date, transesophageal echocardiography (TEE) has been the primary imaging modality used to guide TEER. The role of intracardiac echocardiography (ICE) has not been assessed. The objective of this study was to describe the use and role of 2-dimensional ICE in the early experience of TEER. Methods: Consecutive patients undergoing TEER (with or without concomitant mitral repair) with off-label use of MitraClip (Abbott, Santa Clara, CA) were included in the study. Utilization of 2-dimensional ICE in comparison with TEE imaging were collected in each procedure through retrospective review of the procedural reports and images. Results: Of 42 TEER cases, ICE was used in 15 (36%) and concomitant mitral repair was performed in 37 (86%). ICE was increasingly used over time for TEER. ICE was able to visualize the tricuspid leaflets with high resolution and provided superior leaflet visualization to TEE in 40% of cases where it was used. Patients treated with ICE guidance tended to have a greater baseline severity of tricuspid regurgitation compared with patients treated with TEE guidance alone (8/15 53% massive or greater tricuspid regurgitation versus 6/27 22%; P =0.09). Degree of tricuspid regurgitation reduction was similar with TEE alone versus ICE plus TEE guidance (1.9±1.0 versus 2.1±1.1 grade reduction, P =0.28). Conclusions: ICE was increasingly used in the early experience of TEER over time. ICE facilitates leaflet visualization for grasping and is a useful adjunct to TEE during TEER.
Eleid et al. (Fri,) conducted a observational in Severe tricuspid regurgitation (n=42). Intracardiac echocardiography (ICE) plus transesophageal echocardiography (TEE) vs. Transesophageal echocardiography (TEE) alone was evaluated on Degree of tricuspid regurgitation reduction (p=0.28). Intracardiac echocardiography guidance during tricuspid edge-to-edge repair yielded similar tricuspid regurgitation reduction compared to TEE alone (2.1 vs 1.9 grade reduction, P=0.28).