Transjugular Tricuspid Valve Edge-to-Edge Repair
Recommended Citation
Giacaman A, Fram G, Alter J, Engel Gonzalez P, Frisoli T, Lee J, Zwieg B, Dawdy J, O’Neill B, Villablanca P. Transjugular Tricuspid Valve Edge-to-Edge Repair. JACC Case Rep. 2026;31(36):109516.
Document Type
Article
Publication Date
9-9-2026
Publication Title
JACC Case Rep
Abstract
BACKGROUND: Transcatheter tricuspid valve edge-to-edge repair (TV TEER) is an established option for selected high-risk patients with severe tricuspid regurgitation (TR), but procedural success depends on favorable device trajectory and coaxiality.
CASE SUMMARY: A 79-year-old man with wild-type transthyretin amyloidosis, atrial fibrillation status post left atrial appendage closure, pulmonary hypertension, chronic kidney disease, and recurrent heart failure admissions presented with NYHA functional class III symptoms and torrential functional TR. Imaging showed severe right-sided dilation and a prominent Eustachian ridge. Transfemoral TV TEER was attempted but failed because the ridge displaced the delivery system anteriorly and septally, preventing adequate alignment. The procedure was converted to a right internal jugular approach, allowing successful implantation of 2 clips and reduction of TR from torrential to mild without significant gradient.
DISCUSSION: A prominent Eustachian ridge may complicate transfemoral TV TEER. In selected anatomically challenging cases, a transjugular approach can provide a useful alternative for successful repair.
PubMed ID
42501030
Volume
31
Issue
36
First Page
109516
Last Page
109516
