Table 1.
Pre-procedural TEE | Intra-procedural TEE |
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Degree of TR and presence of tricuspid stenosis. Quality of the TEE imaging for procedural guidance with the patient in the supine position. Coexisting of non-tricuspid valve disease. Annular dimensions and leaflet length. |
Annuloplasty repair: -3D TEE atrial surgical-like view and multiplane 2D views to assess the position of the anchors. - Assess annular depth from the hinge point of the leaflet. -Evaluate distance from the RCA. |
Morphologic characterization and classification of tricuspid leaflets. Location of targeted jet origin and evaluation of coaptation defect(s). Rule out right chamber thrombus and lead-related complications. |
Edge-to-edge repair: -Bi-plane sweeping views from the 60° mid esophagheal to assess trajectory, position relative to the target jet and leaflet grasping. - Transgastric short-axis view for assessment of rotation and perpendicularity. |
Subvalvular apparatus characterization: calcification, number, and position of chordae tendineae. | Replacement: -High-support guidewire localization in the tricuspid annulus. -System coaxiality and depth. |
Rule out thrombus. | Final hemodynamic assessment: residual TR, tricuspid gradients. |