Technique and Preliminary Results of Sole-echocardiography-guided Tricuspid Transcatheter Edge-to-edge Repair without the Use of Fluoroscopy

• Published in: Reviews in cardiovascular medicine 2024-11, Vol.25 (11), p.413
• Main Authors: Gao, Manchen, Shi, Hao, Wang, Cheng, Meng, Hong, Wang, Jiande, Zhu, Da, Luo, Zhiling, Wang, Chuangshi, Li, Ziping, Chang, Junke, Zhang, Fengwen, Pan, Xiangbin, Wang, Shouzheng
• Format: Article
• Language: English
• Subjects: echocardiography; Original Research; sole-echocardiography-guided; tricuspid regurgitation; tricuspid transcatheter edge-to-edge repair
• ISSN: 2153-8174; 1530-6550; 2153-8174
• DOI: 10.31083/j.rcm2511413

Tricuspid transcatheter edge-to-edge repair (T-TEER) has emerged as an attractive option for severe tricuspid regurgitation (TR). To avoid the radiation exposure for both patients and medical staff, we propose a sole-echocardiography-guided method for T-TEER. The purpose of this article was to investigate the feasibility of sole-echocardiography-guided T-TEER. This was a retrospective observational study, including 43 patients who underwent sole-echocardiography-guided T-TEER at two medical centers in China between June 2022 and September 2023. Clinical and echocardiographic data were collected at baseline, discharge and 6-month follow-up. Patients enrolled in this study were elderly (71.6 ± 8.2 years) with significant comorbidities, 67.4% had baseline massive or torrential TR and 76.7% were classified as New York Heart Association (NYHA) functional class III/IV. All patients achieved successful device implantation, and no severe device-related complications or mortality occurred during the follow-up period. Significantly reduced TR and reversed right ventricular remodeling were observed at 6-month follow-ups. Patients classified as NYHA functional class I/II increased from 23.3% at baseline to 81.4% at 6-month follow-up ( < 0.001). Sole-echocardiography-guided T-TEER has a low incidence of complications and can effectively reduce TR. It is feasible to substitute conventional fluoroscopy and echocardiography guidance for echocardiography guidance alone. Further large-scale randomized controlled trials are needed to validate the safety, efficacy and patient benefits of this technique.