Fusion imaging guided implantation of a Tricento transcatheter heart valve for severe tricuspid regurgitation

Abstract

We report the case of a 64‐year‐old patient with history of chronic kidney disease on dialysis who was repeatedly hospitalized due to hydropic decompensation. Right heart failure with secondary severe tricuspid regurgitation was diagnosed. An interventional approach was recommended due to the heavy calcification of the sinus venosus and the perioperative risk (EuroScore II 3.2%) and taking into account the explicit request of the patient. After analysis of a full‐cycle computed tomography, the patient was eligible for the implantation of the Tricento transcatheter heart valve. The custom‐made prosthesis was implanted successfully using periprocedural transoesophageal guidance supported by fusion imaging that integrates live co‐registration. After implantation of the valve prosthesis, the primary result was excellent. The patient was discharged without further complications shortly after the procedure and her status is being closely monitored.

Caval Valve Implantation (CAVI): An Emerging Therapy for Treating Severe Tricuspid Regurgitation

“…There remains scarce data regarding the safety, performance, efficacy or durability of the Tricento ® Valve system ( Table 2 ). The totality of evidence is currently summarized by case reports and, to best of our knowledge, there is not an ongoing prospective study assessing this device [ 36 , 37 ]. However, particularly in patients with challenging anatomies, there may be some benefit from a customized device such as Tricento ® .…”

Multimodality imaging for transcatheter tricuspid valve repair and replacement

“…After deployment, right ventriculography and bicaval angiography are performed to evaluate continence of the valvular element and assess for endoleaks. Fusion imaging of echocardiographic and CT imaging with fluoroscopic projections has also been described to guide deployment ( 88 , 89 ).…”

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

“…The benefits of fusion imaging have been shown for some structural transcatheter procedures, such as a reduced procedure time for transeptal puncture for either MitraClip or left atrial appendage closure [66], a decreased fluoroscopy time and radiation dose for atrial septum defect closure [67], and a reduced radiation dose for left atrial appendage closure [68], but there are currently no data evaluating the procedural outcomes of transcatheter tricuspid repair or replacement procedures assisted by fusion imaging, beyond individual case experience [40,[69][70][71][72][73][74].…”