Three-Dimensional Intracardiac Echocardiography for Tricuspid Transcatheter Edge-to-Edge Repair.

Patients with severe symptomatic tricuspid regurgitation face a significant dilemma in treatment options, as the yearly mortality with medical therapy and the surgical mortality for tricuspid repair or replacement are high. Transcatheter edge-to-edge repair (TEER) for the tricuspid valve is becoming a viable option in patients, although procedural success is dependent on high-quality imaging. While transesophageal echocardiography remains the standard for tricuspid TEER procedures, intracardiac echocardiography (ICE) with three-dimensional (3D) multiplanar reconstruction (MPR) has many theoretical and practical advantages. The aim of this article was to describe the in vitro wet lab-based imaging work done to facilitate the best approach to 3D MPR ICE imaging and the procedural experience gained with 3D MPR ICE in tricuspid TEER procedures with the PASCAL device.

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© 2022 The Author(s).

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Scott M. Chadderdon received grant support from Medtronic Inc and GE Healthcare Imaging and is an imaging education consultant for Edwards Lifesciences and Medtronic Inc. Firas E. Zahr received grant support from Siemens Healthineers Inc and is an education consultant for Medtronic Inc. Howard K. Song is an education consultant for Medtronic Inc. Raj Makkar received grant support from Edwards Lifesciences and St. Jude Medical and personal fees from Abbott Vascular, Cordis, Medtronic Inc. Patrick Gleason received research grants from Edwards Lifesciences, Medtronic Inc, and Abbott. Susheel Kodali is a consultant for Admedus, Meril Lifesciences, JenaValve, Abbott Vascular. Equit in Dura Biotech, MicroInterventional Devices, Thubrikar Aortic Valve Inc, and Supira, Admedus. Rebecca T. Hahn received speaker fees from Abbott Structural, Baylis Medical, and Edwards Lifesciences; has institutional educational and consulting contracts for which she receives no direct compensation with Abbott Structural, Boston Scientific, Edwards Lifesciences, and Medtronic; has equity with Navigate; and is the chief scientific officer for the Echocardiography Core Laboratory at the Cardiovascular Research Foundation for multiple industry-sponsored trials, for which she receives no direct industry compensation. Paul Grayburn received research grants from Abbott Vascular, Edwards Lifesciences, Medtronic, W.L. Gore, Cardiovalve, and Neochord; serves on advisory boards of and received honoraria from Abbott Vascular, Edwards Lifesciences, Medtronic, W.L. Gore, and 4C Medical. Robert L. Smith received institutional grant support from Edwards Lifesciences, Abbott, and Cryolife; serves on the advisory board for Edwards Lifesciences; and is a speaker for Abbott and Cryolife. D. Scott Lim received grant support (institutional) from Abbott, Boston Scientific, Edwards, Medtronic; and consulting (personal) from Keystone, Valgen, Venus, Gore. William A. Gray received consultant fees from Edwards Lifesciences. Florian Deuschl is a full-time employee of Edwards Lifesciences. Charles Davidson received research grant support and consultant for Edwards Lifesciences. The other authors had no conflicts to declare.