JACC. Case reports · 2026
Isolated Transcatheter Tricuspid Valve Edge-to-Edge Repair in Repaired Tetralogy of Fallot.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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Ошибки и ограничения
История · было → стало
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Azizi Omar, Jalal Zakaria, Ternacle Julien, Leroux Lionel, Thambo Jean-Benoit, Iriart Xavier
Аннотация
BACKGROUND: Adults with repaired tetralogy of Fallot (rTOF) frequently develop right heart failure, most commonly related to pulmonary regurgitation. Tricuspid regurgitation (TR) is an underrecognized contributor. Transcatheter edge-to-edge repair (TEER) has emerged as an alternative to surgery, but evidence in congenital heart disease remains limited.
CASE SUMMARY: We report the first case of isolated tricuspid valve repair using TriClip in an adult with rTOF and severe symptomatic TR. Preprocedural transesophageal echocardiography demonstrated type IIIb anatomy with a 6-mm coaptation gap. The initial clip entrapment resulted in chordal rupture and transient TR worsening. Two additional clips were successfully implanted, leading to significant TR reduction and clinical improvement.
DISCUSSION: This case highlights both the feasibility and technical challenges of TEER in complex congenital anatomy.
TAKE-HOME MESSAGES: TR contributes to right heart failure in rTOF. The tricuspid subvalvular apparatus may be fragile; nevertheless, TEER remains feasible and clinically beneficial in selected patients.
CASE SUMMARY: We report the first case of isolated tricuspid valve repair using TriClip in an adult with rTOF and severe symptomatic TR. Preprocedural transesophageal echocardiography demonstrated type IIIb anatomy with a 6-mm coaptation gap. The initial clip entrapment resulted in chordal rupture and transient TR worsening. Two additional clips were successfully implanted, leading to significant TR reduction and clinical improvement.
DISCUSSION: This case highlights both the feasibility and technical challenges of TEER in complex congenital anatomy.
TAKE-HOME MESSAGES: TR contributes to right heart failure in rTOF. The tricuspid subvalvular apparatus may be fragile; nevertheless, TEER remains feasible and clinically beneficial in selected patients.