A New Transesophageal Echocardiography Guidance Protocol for
Edge-to-Edge Repair of the Tricuspid Valve – The “Mainz Approach”
Abstract
Intraprocedural transesophageal echocardiography (TEE) guidance plays an
essential role in transcatheter repair therapy of the tricuspid valve
(TV). So far, several different imaging concepts are in use. However, an
imaging protocol that fully addresses the morphological complexity of
the TV and further offers efficacious workarounds for the frequently
occurring restrictions of TV imaging is still missing. As a tertiary
referral center with a large experience of more than 250 cases of
transcatheter edge-to-edge repair (TEER) of the TV performed at the
Heart Valve Center in Mainz/Germany, we have constantly adapted our
periinterventional echocardiographic approach to accomplish both. As a
key measure for success, we intensely rely on the transgastric acoustic
windows that not only delivers high-resolution information on the
morphology of the TV and all relevant procedural steps but also help to
avoid the frequent shadowing artefacts experienced in transesophageal
imaging.