A 57-year-old woman presented with progressive New York Heart Association (NYHA) class III dyspnea, edema and fatigue. Past history included hypertrophic cardiomyopathy with recent implantable cardioverter-defibrillator (ICD) lead extraction due to high impedance, followed by subcutaneous ICD implantation. Echocardiography subsequently demonstrated torrential tricuspid regurgitation (TR) with posterior leaflet flail and a 15 mm flail gap (Figure 1A-1C, Moving Images 1-3). The right ventricle (RV) was dilated with normal function, left ventricular (LV) function was preserved with normal pulmonary pressures. After Heart Team review, the patient underwent transcatheter tricuspid valve repair (TTVr) with the modified TriClip/MitraClip G4 system (Abbott, Santa Clara, USA).
2. Division of Cardiology, St. Michael's Hospital, University of Toronto, Toronto, ON, Canada
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