Transcatheter tricuspid valve replacement with a self-expanding bioprosthesis Andrea Colli, MD, PhD, Gino Gerosa, MD, Krzysztof Bartus, MD, PhD, Giuseppe.

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Presentation transcript:

Transcatheter tricuspid valve replacement with a self-expanding bioprosthesis Andrea Colli, MD, PhD, Gino Gerosa, MD, Krzysztof Bartus, MD, PhD, Giuseppe Tarantini, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 156, Issue 3, Pages 1064-1066 (September 2018) DOI: 10.1016/j.jtcvs.2018.03.096 Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Preprocedural assessment on cardiac computed tomography. A, Volume-rendered cardiac computed tomography shows the right coronary artery course parallel to the right atrioventricular junction. B, Right-sided heart access route simulation. C, Three-dimensional tricuspid annulus segmentation. D, Long-axis view with simulated GATE conical device (38-52 mm diameters, height 21 mm; NaviGate Cardiac Structures Inc, Lake Forest, Calif). E, Prediction of fluoroscopy angulation (3mensio Structural Heart version 9.0 SP1; Pie Medical Imaging, Maastricht, The Netherlands). The Journal of Thoracic and Cardiovascular Surgery 2018 156, 1064-1066DOI: (10.1016/j.jtcvs.2018.03.096) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Fluoroscopic images summarizing procedural steps. A, Simultaneous right coronary artery angiography and right ventriculography for assessment of the deployment area. B, An Amplatzer SuperStiff guidewire (Abbott Laboratories, Abbott Park, Ill) was placed into the right pulmonary artery (a). A left ventricular guidewire was used as rescue pacemaker lead (b). Right coronary artery (c) and right ventriculography pigtail (d) catheters can be seen. C, A 42F introducer (a) and a tracheal tube for lung ventilation (b) were placed. D, The delivery system was advanced into the cavoatrial junction. E, The delivery system was positioned orthogonal to the tricuspid annulus. F, Partial GATE prosthesis (NaviGate Cardiac Structures Inc, Lake Forest, Calif) deployment. G, Complete deployment of the GATE prosthesis. H, Final appearance of the GATE prosthesis with respect to the right coronary artery. The Journal of Thoracic and Cardiovascular Surgery 2018 156, 1064-1066DOI: (10.1016/j.jtcvs.2018.03.096) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Echocardiographic Imaging before and after the procedure. A, Preoperative 2-dimensional transthoracic echocardiography shows severe annular dilatation. B, Color Doppler echocardiography shows severe tricuspid regurgitation. C, Preoperative 3-dimensional echocardiography of the tricuspid valve. D, Postoperative 2-dimensional transthoracic echocardiography shows the GATE prosthesis (NaviGate Cardiac Structures Inc, Lake Forest, Calif) in the tricuspid position. E, Color Doppler echocardiography shows the presence of mild septal paravalvular regurgitation. F, Postoperative 3-dimensional echocardiography visualization of the GATE prosthesis. The Journal of Thoracic and Cardiovascular Surgery 2018 156, 1064-1066DOI: (10.1016/j.jtcvs.2018.03.096) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Fluoroscopic images summarizing procedural steps. The Journal of Thoracic and Cardiovascular Surgery 2018 156, 1064-1066DOI: (10.1016/j.jtcvs.2018.03.096) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions

Video 1 Transcatheter tricuspid valve replacement with GATE (NaviGate Cardiac Structures Inc, Lake Forest, Calif) bioprosthesis: preprocedural evaluation, procedural steps, and postprocedural assessment. Preop, Preoperative; 2D-TTE, 2-dimensional transthoracic echocardiography; 3D-TTE, 3-dimensional transthoracic echocardiography; CT, computed tomography; RCA, right coronary artery; AV, atrioventricular; RA, right atrium; RV, right ventricle; PA, pulmonary artery; postop, postoperative. Video available at: https://www.jtcvs.org/article/S0022-5223(18)30877-8/fulltext. The Journal of Thoracic and Cardiovascular Surgery 2018 156, 1064-1066DOI: (10.1016/j.jtcvs.2018.03.096) Copyright © 2018 The American Association for Thoracic Surgery Terms and Conditions