Transcatheter Tricuspid Repair With the Use of 4-Dimensional Intracardiac Echocardiography

Davidson, Charles J.; Abramson, Sandra; Smith, Robert L.; Kodali, Susheel; Kipperman, Robert; Eleid, Mackram F.; Reisman, Mark; Whisenant, Brian; Puthumana, Jyothy; Fowler, Dale; Grayburn, Paul A.; Hahn, Rebecca T.; Koulogiannis, Konstantinos; Pislaru, Sorin; Zwink, Todd; Minder, Michael; Deuschl, Florian; Feldman, Ted; Gray, William A.; Lim, D. Scott

doi:10.1016/j.jcmg.2021.01.029

Cited by 26 publications

(10 citation statements)

References 2 publications

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“…The first generation of 4D ICE (ACUSON AcuNav Volume ICE Catheter, Siemens, Malvern, PA) has been studied in the initial experience of tricuspid percutaneous annuloplasty, where it was particularly useful in identifying the hinge point of the tricuspid leaflets at the tricuspid annulus for anchor implantation. 16 In addition to real-time 3D imaging capability, this first generation 4D ICE probe has the advantage of increased catheter stiffness, allowing more consistent and stable catheter position; however, it is limited by suboptimal 2D resolution which is needed for tricuspid leaflet grasping and thus we have not found it to be useful for TEER. Although frequent repositioning of the low-profile currently available 2D ICE catheters is needed due to their flexible, nonstiff properties, this can be mitigated to some degree with the use of a long steerable guiding catheter.…”

Section: Discussionmentioning

confidence: 99%

Utility of Intracardiac Echocardiography in the Early Experience of Transcatheter Edge to Edge Tricuspid Valve Repair

Eleid

Alkhouli

Thaden

et al. 2021

Circ: Cardiovascular Interventions

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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.

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Section: Discussionmentioning

confidence: 99%

Utility of Intracardiac Echocardiography in the Early Experience of Transcatheter Edge to Edge Tricuspid Valve Repair

Eleid

Alkhouli

Thaden

et al. 2021

Circ: Cardiovascular Interventions

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“…4D volumetric imaging ICE can bring great changes in tricuspid valve intervention. 4D volumetric imaging ICE is superior to TEE for visualization of the tricuspid annulus, especially the lateral annulus, and can be used for transcatheter annuloplasty, valve repair, and valve replacement for tricuspid in competence ( 140 , 143 ). It should be noted that intravenous anesthetic drugs reduce systemic pressure while mechanical ventilation increases intrathoracic pressure.…”

Section: Application Of Intracardiac Echocardiography In Intervention...mentioning

confidence: 99%

Intracardiac echocardiography Chinese expert consensus

Zhong

Huimin

et al. 2022

Front. Cardiovasc. Med.

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In recent years, percutaneous catheter interventions have continuously evolved, becoming an essential strategy for interventional diagnosis and treatment of many structural heart diseases and arrhythmias. Along with the increasing complexity of cardiac interventions comes ever more complex demands for intraoperative imaging. Intracardiac echocardiography (ICE) is well-suited for these requirements with real-time imaging, real-time monitoring for intraoperative complications, and a well-tolerated procedure. As a result, ICE is increasingly used many types of cardiac interventions. Given the lack of relevant guidelines at home and abroad and to promote and standardize the clinical applications of ICE, the members of this panel extensively evaluated relevant research findings, and they developed this consensus document after discussions and correlation with front-line clinical work experience, aiming to provide guidance for clinicians and to further improve interventional cardiovascular diagnosis and treatment procedures.

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“…A guidewire in the right coronary artery serves as landmark to facilitate orientation. The use of ICE can be helpful in cases with demanding anatomy [13]. In the final step, the band is contracted (up to maximum of 5.5 cm depending on the size of the cardioband) before it is released from the implant catheter.…”

Section: Cardioband Tricuspid Valve Reconstruction Systemmentioning

confidence: 99%

Tricuspid Annuloplasty: Transcatheter Approaches

2021

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Purpose of Review New transcatheter techniques to perform tricuspid annuloplasty are evolving and are introduced into the clinical routine. Yet, clinical experience is limited. Recent Findings Currently, 3 different techniques for tricuspid annuloplasty have been used in larger clinical cohorts. They can be divided into direct annuloplasty techniques and suture plication techniques. The largest clinical evidence is related to direct annuloplasty techniques. It has been shown that annular dimensions can be effectively reduced. This translates into an improvement of the degree of tricuspid regurgitation and improvement of clinical symptoms. Due to the newness of this type of therapy, long-term data is limited, but for one of the described techniques, published data show that the positive effects persist over a 2-year period. Summary Transcatheter approaches are safe and are able to treat tricuspid regurgitation effectively. There are still differences in the efficacy of the different techniques. Clinical experience varies among the different approaches.

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Transcatheter Tricuspid Repair With the Use of 4-Dimensional Intracardiac Echocardiography

Cited by 26 publications

References 2 publications

Utility of Intracardiac Echocardiography in the Early Experience of Transcatheter Edge to Edge Tricuspid Valve Repair

Utility of Intracardiac Echocardiography in the Early Experience of Transcatheter Edge to Edge Tricuspid Valve Repair

Intracardiac echocardiography Chinese expert consensus

Tricuspid Annuloplasty: Transcatheter Approaches

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