Simultaneous use of transesophageal and intracardiac echocardiography enabled successful transcatheter tricuspid valve replacement with the EVOQUE device in two patients with poor standard TEE imaging.
Case Report (n=2)
No
Does simultaneous TEE and ICE guidance enable successful EVOQUE transcatheter tricuspid valve replacement in patients with severe tricuspid regurgitation and poor TEE imaging?
Simultaneous use of TEE and ICE is a feasible imaging strategy to guide transcatheter tricuspid valve replacement with the EVOQUE device in patients with poor standard TEE imaging.
OBJECTIVE: We demonstrate a step-by-step intraprocedural imaging guide using transesophageal echocardiography (TEE) and intracardiac echocardiography (ICE) to guide EVOQUE in cases with poor intraprocedural imaging. KEY STEPS: ICE right ventricular (RV) inflow/outflow view with biplane along with 3-dimensional (3D) multiplanar reconstruction (MPR). TEE gastric views for wire placement. ICE 3D MPR to guide delivery system and device depth. Anchors to leaflet relationship; adequate leaflet capture using 3D ICE. Confirm posterior leaflet capture using 2-dimensional (2D) and 3D TEE gastric images. Atrial and ventricular expansion of device using 3D and 2D ICE. 3D MPR ICE to guide wire out of the RV. Assess final results. POTENTIAL PITFALLS: Frame rate of 3D MPR on ICE is lower than that of TEE, cost of ICE catheters, lack of reimbursement for ICE.
Quader et al. (Sun,) conducted a case report in Severe tricuspid regurgitation (n=2). Simultaneous transesophageal echocardiography (TEE) and intracardiac echocardiography (ICE) guided EVOQUE placement was evaluated on Successful device placement. Simultaneous use of transesophageal and intracardiac echocardiography enabled successful transcatheter tricuspid valve replacement with the EVOQUE device in two patients with poor standard TEE imaging.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: