Related Experiment Video
Updated: Jan 14, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
First Experience of Tricuspid Transcatheter-Edge-to-Edge Repair Using 3D Mini-Transesophageal Echocardiography and
Mohamed Ibrahim1, Sina O'Sullivan2, Abdallah El Sabbagh2
1Department of Internal Medicine, Mayo Clinic, Jacksonville, Florida, USA.
Objectives:
To describe the first experience of using a 9-mm miniature transesophageal echocardiography (TEE) probe combined with intracardiac echocardiography (ICE) to safely guide tricuspid transcatheter edge-to-edge repair (TEER) in a patient with large esophageal varices and advanced liver disease.
Key Steps:
Multidisciplinary evaluation identified severe tricuspid regurgitation in a patient with cirrhosis and suspected hepatocellular carcinoma. Hemodynamic and anatomic assessment was conducted with transthoracic echocardiography, TEE, coronary computed tomography angiogram, and right heart catheterization. A 9-mm miniature TEE probe was selected to minimize esophageal trauma, and 2 TriClip XTW devices were successfully implanted with combined TEE and intracardiac echocardiography guidance. Postprocedural optimization enabled safe progression to Y-90 radioembolization.
Potential Pitfalls:
Miniature TEE probes have limited resolution, reduced three-dimensional imaging, and shorter shaft length, requiring operator experience and adjunct imaging to ensure procedural success.
Take-Home Message:
Miniature TEE enables safe imaging in high-risk esophageal anatomy. Individualized imaging strategies can expand access to structural interventions in complex patients.
