UTILITY OF INTRACARDIAC ECHOCARDIOGRAPHY IN EARLY COMMERCIAL TRANSCATHETER TRICUSPID VALVE REPLACEMENT
Recommended Citation
Fram G, Dawdy J, Alrayes H, Kar Lok Lai L, Chou A, Zweig B, Parikh S, Engel Gonzalez P, Villablanca PA, Frisoli TM, O’Neill BP, Lee JC. UTILITY OF INTRACARDIAC ECHOCARDIOGRAPHY IN EARLY COMMERCIAL TRANSCATHETER TRICUSPID VALVE REPLACEMENT. J Am Coll Cardiol 2025; 85(12):953.
Document Type
Conference Proceeding
Publication Date
4-1-2025
Publication Title
J Am Coll Cardiol
Keywords
cohort analysis, conference abstract, human, intracardiac echocardiography, major clinical study, New York Heart Association class, retrospective study, transesophageal echocardiography, tricuspid valve prosthesis, tricuspid valve regurgitation, tricuspid valve replacement
Abstract
Background: Transcatheter tricuspid valve replacement (TTVR) with the Evoque Valve (Edwards, USA) is a recent commercially available treatment for patients with severe tricuspid regurgitation. Procedural success is highly dependent on intraprocedural imaging quality. Methods TTVR was performed on 57 patients at a large quaternary center between February and September 2024, with intraprocedural imaging primarily driven by transesophageal echocardiography (TEE). In select patients, concomitant TEE and 3-D intracardiac echocardiography (ICE) was used. A retrospective review of baseline characteristics and procedural outcomes was conducted. Results In 14 (24.5%) vs 43 (75.5%) of 57 patients, ICE + TEE vs. TEE alone were used to assist with intraprocedural imaging. Decisions about use of imaging modality were made at the operatorʼs discretion, dependent on TEE imaging quality. ICE utilization increased over time, as seen in figure 1A. Patients had similar baseline characteristics, however patients for whom ICE was used had worse NYHA symptoms prior to procedure (NYHA IV, 21% vs. NYHA IV, 5%, p=0.03), as seen in figure 1B. There was a signal towards higher procedural success in patients for whom ICE and TEE was used, as compared to TEE alone (n=14, 100% vs. n=34, 79%, p=0.095). [Formula presented] Conclusion ICE facilitates procedural success in TTVR patients, particularly assisting with visualization of leaflets interaction with the anchors of the TTVR. ICE with TEE to guide TTVR was increasingly used over time.
Volume
85
Issue
12
First Page
953
