Imaging for Tricuspid Valve Repair and Replacement

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Imaging

Background:

• Tricuspid regurgitation (TR) poses a significant healthcare challenge, often undertreated.
• Recent guideline updates and transcatheter tricuspid valve interventions (TTVI) have increased focus on tricuspid valve (TV) treatment.
• TTVI encompasses various techniques including annuloplasty, leaflet repair, and valve replacement.

Purpose of the Study:

• To highlight the critical role of multimodality imaging in TTVI.
• To outline the key imaging applications throughout the TTVI process.
• To emphasize the importance of accurate imaging for optimal patient selection and procedural success.

Main Methods:

• Utilizing multimodality imaging for pre-procedural assessment, including TR severity, mechanism, and RV function.
• Employing imaging guidance during TTVI procedures.
• Assessing and monitoring procedural outcomes with imaging post-intervention.

Main Results:

• Multimodality imaging is essential for patient selection and procedural planning in TTVI.
• Imaging guides and monitors the TTVI procedure, with potential enhancement through modality fusion (e.g., echocardiography and fluoroscopy).
• Pre-procedural imaging accurately quantifies TR severity, identifies mechanisms, and assesses RV dysfunction and pulmonary hypertension.

Conclusions:

• Multimodality imaging is indispensable for successful TTVI, from initial assessment to long-term follow-up.
• Accurate imaging facilitates the selection of the appropriate TTVI strategy for individual patients.
• Enhanced procedural guidance through fused imaging modalities can improve TTVI outcomes.