Advances in Imaging for Tricuspid Transcatheter Edge-to-Edge Repair: Lessons Learned and Future Perspectives

Prandi, Francesca Romana; Belli, Martina; Illuminato, Federica; Margonato, Davide; Barone, Lucy; Muscoli, Saverio; Chiocchi, Marcello; Laudazi, Mario; Marchei, Massimo; Luozzo, Marco Di; Kini, Annapoorna; Romeo, Francesco; Barillà, Francesco

doi:10.3390/jcm12103384

Cited by 3 publications

(1 citation statement)

References 90 publications

(178 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Without automated multimodal image integration, interventionalists are required to mentally overlay features from multiple modalities together [ 45 ] while performing a procedure. Such mental integration can be a daunting task.…”

Section: Review Of Existing Multimodal Image Integration Techniquesmentioning

confidence: 99%

Advances in TEE-Centric Intraprocedural Multimodal Image Guidance for Congenital and Structural Heart Disease

Zhang,

Gosnell,

Nainamalai

et al. 2023

Diagnostics

View full text Add to dashboard Cite

Percutaneous interventions are gaining rapid acceptance in cardiology and revolutionizing the treatment of structural heart disease (SHD). As new percutaneous procedures of SHD are being developed, their associated complexity and anatomical variability demand a high-resolution special understanding for intraprocedural image guidance. During the last decade, three-dimensional (3D) transesophageal echocardiography (TEE) has become one of the most accessed imaging methods for structural interventions. Although 3D-TEE can assess cardiac structures and functions in real-time, its limitations (e.g., limited field of view, image quality at a large depth, etc.) must be addressed for its universal adaptation, as well as to improve the quality of its imaging and interventions. This review aims to present the role of TEE in the intraprocedural guidance of percutaneous structural interventions. We also focus on the current and future developments required in a multimodal image integration process when using TEE to enhance the management of congenital and SHD treatments.

show abstract

Section: Review Of Existing Multimodal Image Integration Techniquesmentioning

confidence: 99%

Advances in TEE-Centric Intraprocedural Multimodal Image Guidance for Congenital and Structural Heart Disease

Zhang,

Gosnell,

Nainamalai

et al. 2023

Diagnostics

View full text Add to dashboard Cite

show abstract

Impact of Leaflet-to-Annulus Index on Residual Regurgitation Following Transcatheter Edge-to-Edge Repair of the Tricuspid Valve

Pizzino,

Trimarchi,

D’Agostino

et al. 2024

JCM

View full text Add to dashboard Cite

Background: The mismatch between tricuspid valve (TV) leaflet length and annulus dilation, assessed with the septal–lateral leaflet-to-annulus index (SL-LAI), predicts residual tricuspid regurgitation (TR) following tricuspid transcatheter edge-to-edge-repair (T-TEER). When posterior leaflet grasping is required, the anterior–posterior leaflet-to-annulus index (AP-LAI) may offer additional information. Methods: This single-center retrospective cohort study included all patients referred for T-TEER with severe and symptomatic TR with high surgical risk from April 2021 to March 2024. Patients were categorized into ‘optimal result’ (<moderate TR) or ‘suboptimal result’ (≥moderate TR) groups. The SL-LAI and AP-LAI were calculated using pre-procedural transesophageal echocardiography (TEE) measurements. Results: Of the 25 patients, 12 had suboptimal post-procedural results, while 13 showed optimal outcomes. The optimal result group showed a higher prevalence of type IIIA-IIIB TV morphology (85% vs. 45%, p < 0.05), a wider SL annulus diameter (42.5 ± 5 vs. 37 ± 5 mm, p < 0.05), and a longer posterior leaflet length (28 ± 4 vs. 22 ± 5 mm, p < 0.01). The SL-LAI was lower in the optimal group (1 ± 0.2 vs. 1.2 ± 0.32, p < 0.05), while the AP-LAI was higher (0.7 ± 0.1 vs. 0.5 ± 0.2, p < 0.05). ROC curve analysis showed that the AUC for the AP-LAI was 0.769 (95% CI 0.51–0.93, p < 0.05) and Youden test identified the best cut-off value <0.5 (sensitivity 50% and specificity 100%) for a suboptimal result. The SL-LAI showed a very low AUC in predicting suboptimal results (0.245, 95% CI 0.08–0.47). Comparing the two ROC curves, we showed that AUC difference is significant with the AP-LAI showing the best association with the outcome (p = 0.01). Conclusions: The AP-LAI and SL-LAI can help in predicting post T-TEER results, ameliorating patients’ outcomes and avoiding futile procedures.

show abstract

Key Imaging Factors for Transcatheter Management of Tricuspid Regurgitation: Device and Patient Selection

Cannata,

Stankowski,

Galasso

et al. 2024

JCM

View full text Add to dashboard Cite

The growing awareness of tricuspid regurgitation (TR) and the fast-expanding array of devices aiming to percutaneously repair or replace the tricuspid valve have underscored the central role of multi-modality imaging in comprehensively assessing the anatomical and functional characteristics of TR. Accurate phenotyping of TR, the right heart, and pulmonary vasculature via echocardiography, computed tomography, and, occasionally, cardiovascular magnetic resonance and right heart catheterization is deemed crucial in choosing the most suitable treatment strategy for each patient and achieving procedural success. In the first part of the present review, key imaging factors for patient selection will be discussed. In the ensuing sections, an overview of the most commonly used, commercially available systems for transcatheter repair/replacement will be presented, along with their respective selection criteria and information on intraprocedural imaging guidance; these are edge-to-edge repair, orthotopic and heterotopic replacement, and valve-in-valve procedures.

show abstract

Advances in Imaging for Tricuspid Transcatheter Edge-to-Edge Repair: Lessons Learned and Future Perspectives

Cited by 3 publications

References 90 publications

Advances in TEE-Centric Intraprocedural Multimodal Image Guidance for Congenital and Structural Heart Disease

Advances in TEE-Centric Intraprocedural Multimodal Image Guidance for Congenital and Structural Heart Disease

Impact of Leaflet-to-Annulus Index on Residual Regurgitation Following Transcatheter Edge-to-Edge Repair of the Tricuspid Valve

Key Imaging Factors for Transcatheter Management of Tricuspid Regurgitation: Device and Patient Selection

Contact Info

Product

Resources

About