Tricuspid transcatheter edge-to-edge repair is a safe and effective option to treat symptomatic severe tricuspid regurgitation (TR). 1 However, procedural success remains limited by several anatomical challenges, including large coaptation gaps, that are known to be a predictor of procedural failure. 2 Large coaptation gaps are commonly found in patients with advanced atrial TR with significant atrial and tricuspid annulus dilatation.
To effectively reduce TR in these patients, multiple clips are often required. In our experience, these patients have the best result with “bicuspidization” of the tricuspid valve through a “zipping technique.” Specifically, the first clip is placed near the anteroseptal commissure to set the stage for the next clip to reduce the remaining coaptation gap. Subsequent clips are placed more centrally adjacent to the prior clip, resulting in a “bicuspid” tricuspid valve, by bringing together the anterior and …
Autori
Giulia Passaniti, Gilbert HL Tang, Richard Tanner, Samin K Sharma, Annapoorna S Kini, Stamatios Lerakis