State-of-the-Art Review: Anatomical and Imaging Considerations During Transcatheter Tricuspid Valve Repair Using an...

Area of Science:

• Cardiovascular Medicine
• Interventional Cardiology
• Medical Device Technology

Background:

• Transcatheter techniques for tricuspid regurgitation (TR) are increasingly utilized, with numerous devices under development.
• Secondary TR, prevalent in 90% of patients, makes catheter-based systems targeting annular dilation particularly relevant.

Purpose of the Study:

• To highlight the fundamental importance of anatomical knowledge for effective and safe transcatheter tricuspid annuloplasty.
• To emphasize the necessity of understanding device specifics, delivery systems, and procedural steps.
• To underscore the critical role of multi-modality imaging in guiding each procedural phase.

Main Methods:

• Review of anatomical considerations for tricuspid valve interventions.
• Analysis of device characteristics and delivery system requirements.
• Discussion of multi-modality imaging techniques and optimal imaging planes for procedural guidance.

Main Results:

• Detailed understanding of tricuspid annulus anatomy relative to neighboring structures (aortic root, RCA, electrical pathways, CS) is crucial.
• Comprehensive knowledge of device mechanics and procedural steps is essential for successful annuloplasty.
• Appropriate selection of imaging modalities and planes at each procedural step is vital for optimal guidance.

Conclusions:

• Successful transcatheter tricuspid annuloplasty relies on a synthesis of anatomical knowledge, device familiarity, and expert application of multi-modality imaging.
• Precise imaging guidance is paramount for ensuring the safety and efficacy of these evolving interventional procedures.