PMID- 37841046
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20231020
IS  - 2514-2119 (Electronic)
IS  - 2514-2119 (Linking)
VI  - 7
IP  - 10
DP  - 2023 Oct
TI  - Tailored pre-procedural management and four-clip trans-catheter edge-to-edge 
      repair procedure to efficiently treat torrential tricuspid regurgitation: a case 
      report.
PG  - ytad475
LID - 10.1093/ehjcr/ytad475 [doi]
LID - ytad475
AB  - BACKGROUND: The use of trans-catheter treatment for tricuspid regurgitation (TR) 
      is currently increasing, especially trans-catheter edge-to-edge repair (TEER). 
      However, patients with very large coaptation gaps are usually considered not 
      eligible for this treatment. CASE SUMMARY: We present the case of an 87-year-old 
      man with symptomatic [New York Heart Association (NYHA) functional Class IV, 
      right-sided heart failure signs] isolated torrential TR due to chronic atrial 
      fibrillation who was initially considered not eligible for a tricuspid valve (TV) 
      TEER because of a very large coaptation gap. A leadless pacemaker was implanted, 
      and the patient received high doses of intravenous diuretics at home during 2 
      months. After heart team discussion, he was then considered suitable for a TEER 
      procedure. A 'zipping' technique was performed, with the implantation of four 
      TriClip devices, based on the anatomy of the TV and guided by fluoroscopy and bi- 
      and tri-dimensional trans-oesophageal echocardiography, allowing an excellent 
      procedural result (mild TR and mean TV gradient = 1 mmHg). At 6 months, TR was 
      still mild, the patient reported a remarkable improvement (NYHA I, no heart 
      failure signs), and 6-min walk test increased from 260 to 375 m. DISCUSSION: This 
      case underscores the need for heart valve centres with dedicated and experienced 
      teams and networks of care to adequately manage patients with severe TR from 
      pre-procedural choice of cardiac pacing type and optimization of diuretic therapy 
      to customized interventions with appropriate number and location of clips 
      according to the anatomy of the valve and the mechanism of TR, guided by 
      high-quality bi- and tri-dimensional echocardiography.
CI  - (c) The Author(s) 2023. Published by Oxford University Press on behalf of the 
      European Society of Cardiology.
FAU - Dreyfus, Julien
AU  - Dreyfus J
AUID- ORCID: 0000-0003-1338-3007
AD  - Cardiology Department, Centre Cardiologique du Nord, 32-36 Rue des Moulins 
      Gemeaux, Saint-Denis 93200, France.
FAU - Nakache, Ariel
AU  - Nakache A
AD  - Cardiology Department, Centre Cardiologique du Nord, 32-36 Rue des Moulins 
      Gemeaux, Saint-Denis 93200, France.
FAU - Nejjari, Mohammed
AU  - Nejjari M
AUID- ORCID: 0000-0003-1096-1537
AD  - Cardiology Department, Centre Cardiologique du Nord, 32-36 Rue des Moulins 
      Gemeaux, Saint-Denis 93200, France.
LA  - eng
PT  - Case Reports
DEP - 20230930
PL  - England
TA  - Eur Heart J Case Rep
JT  - European heart journal. Case reports
JID - 101730741
PMC - PMC10568525
OTO - NOTNLM
OT  - Case report
OT  - Management
OT  - Percutaneous valve repair
OT  - Tricuspid regurgitation
COIS- Conflict of interest: Julien Dreyfus and Mohammed Nejjari are proctors for 
      Abbott.
EDAT- 2023/10/16 06:48
MHDA- 2023/10/16 06:49
PMCR- 2023/09/30
CRDT- 2023/10/16 04:26
PHST- 2023/04/01 00:00 [received]
PHST- 2023/09/15 00:00 [revised]
PHST- 2023/09/27 00:00 [accepted]
PHST- 2023/10/16 06:49 [medline]
PHST- 2023/10/16 06:48 [pubmed]
PHST- 2023/10/16 04:26 [entrez]
PHST- 2023/09/30 00:00 [pmc-release]
AID - ytad475 [pii]
AID - 10.1093/ehjcr/ytad475 [doi]
PST - epublish
SO  - Eur Heart J Case Rep. 2023 Sep 30;7(10):ytad475. doi: 10.1093/ehjcr/ytad475. 
      eCollection 2023 Oct.