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Updated: Jun 28, 2026
Echocardiographic Evaluation of Atrial Communications before Transcatheter Closure
Published on: February 8, 2022
Facilitating Tricuspid Edge-to-Edge Repair in Torrential Regurgitation Using Temporary Superior Vena Cava Balloon
Firas Jaly1, Holger Priebe-Brämer1, Boris Dickmann1
1Department of Cardiology, Marien Hospital Witten, Witten, Germany; University Witten/Herdecke, Witten, Germany.
Background:
Transcatheter edge-to-edge repair (TEER) has emerged as the most widely adopted percutaneous therapy for severe tricuspid regurgitation (TR) in patients at high surgical risk. However, large coaptation gaps and severe leaflet tethering remain major anatomical challenges that may preclude successful leaflet grasping.
Case Summary:
We describe 2 patients with torrential TR and large coaptation gaps (15 and 18 mm) who underwent successful tricuspid TEER facilitated by transient superior vena cava (SVC) balloon occlusion. A semicompliant 20-mm valvuloplasty balloon was temporarily inflated within the SVC to reduce venous return and right-sided preload during leaflet grasping. Balloon inflation resulted in marked annular reduction and near-complete elimination of the coaptation gap, enabling successful device implantation and substantial TR reduction in both cases.
Discussion:
Temporary SVC occlusion may represent a useful adjunctive technique to transiently reduce right-sided preload and tricuspid annular dimensions in challenging anatomies with large coaptation gaps, thereby facilitating successful TEER.
