Imaging for Tricuspid Valve Repair and Replacement
Por:
Agricola, E, Asmarats, L, Maisano, F, Cavalcante, JL, Liu, SZ, Milla, F, Meduri, C, Rodes-Cabau, J, Vannan, M, Pibarot, P
Publicada:
1 ene 2021
Ahead of Print:
1 ene 2021
Resumen:
Primary or secondary tricuspid regurgitation (TR) represents an important health care burden and challenge which has often been neglected or undertreated in the past. The expansion and reinforcement of the indications for tricuspid valve (TV) intervention in the 2017 editions of the guidelines as well as the introduction of transcatheter tricuspid valve intervention (TTVI) has considerably increased the attention of the community on the TV and the volume of TV interventions in the past years. Depending on the anatomic target, TTVI can be categorized as the following: 1) direct or indirect tricuspid restrictive annuloplasty; 2) direct (edge-to-edge repair) or indirect (coaptation device) restoration of leaflet coaptation; 3) heterotopic tricuspid valve implantation; and 4) transcatheter tricuspid valve replacement. Multi-modality imaging has crucial role for the following: 1) patient selection for TTVI and procedure planning; 2) guiding and monitoring the procedure; and 3) assessing and following over time the results of the procedure. The key points for pre-procedural imaging are: 1) accurate quantitation of TR severity; 2) proper identification of the mechanism(s) responsible for the TR; and 3) quantitation of RV dysfunction and pulmonary arterial hypertension. This imaging work-up is essential to select the right type of intervention for the right patient and TV. Transesophageal echocardiography and fluoroscopy imaging is also key for guiding the TTVI procedures and fusion between these 2 modalities may further enhance the quality of procedure guiding. (C) 2021 by the American College of Cardiology Foundation.
Filiaciones:
Agricola, E:
Ist Sci San Raffaele, Milan, Italy
Asmarats, L:
Univ Laval, Quebec Heart & Lung Inst, Inst Univ Cardiol & Pneumol Quebec, Quebec City, PQ, Canada
Institut d’Investigació Biomèdica Sant Pau (IIB SANT PAU), Sant Quintí 77-79, 08041 Barcelona, Spain
Maisano, F:
Univ Hosp Zurich, Zurich, Switzerland
Cavalcante, JL:
Minneapolis Heart Inst, Dept Cardiol, Minneapolis, MN USA
Liu, SZ:
Marcus Heart Valve Ctr, Piedmont Heart Inst, Atlanta, GA USA
Milla, F:
Marcus Heart Valve Ctr, Piedmont Heart Inst, Atlanta, GA USA
Meduri, C:
Marcus Heart Valve Ctr, Piedmont Heart Inst, Atlanta, GA USA
Rodes-Cabau, J:
Univ Laval, Quebec Heart & Lung Inst, Inst Univ Cardiol & Pneumol Quebec, Quebec City, PQ, Canada
Vannan, M:
Marcus Heart Valve Ctr, Piedmont Heart Inst, Atlanta, GA USA
Pibarot, P:
Univ Laval, Quebec Heart & Lung Inst, Inst Univ Cardiol & Pneumol Quebec, Quebec City, PQ, Canada
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