TEE Guiding for T-TEER by Using Multiplanar Reconstructions in a Patient With Previous Surgical Annuloplasty

Transesophageal echocardiographic guidance in tricuspid transcatheter edge-to-edge repair may face limitations in imaging, which are sometimes difficult to overcome and lead to an increased risk of periprocedural complications. We present an imaging vignette describing the usefulness of multiplanar reconstructions by 3-dimensional transesophageal echocardiography in a patient with previously implanted surgical tricuspid annuloplasty ring impeding imaging quality. The procedure was conducted successfully by implanting a single device and reducing tricuspid regurgitation from massive to moderate. Multiplanar reconstructions represent a valuable tool with the possibility for improving safety in tricuspid transcatheter edge-to-edge repair by ameliorated visualization of leaflet insertion and grasping.