Transesophageal echocardiography (TEE) is the standard imaging modality for procedural guidance of tricuspid edge-to-edge repair. Typically, 2 TEE views are necessary: a mid-esophageal view to guide leaflet grasping, and a transgastric view to assess the adequacy of tissue bridging. However, TEE imaging at least in one of these views can be challenging due to the remote location of the tricuspid valve from esophagus, the degree of right heart enlargement and cardiac rotation, and the acoustic shadowing from cardiac prostheses. In such situations, intracardiac echocardiography (ICE) can provide complementary images to facilitate the procedure.
2. Department of Cardiovascular Diseases, Mayo Clinic, Rochester, MN
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