PMC6956454_01
A - Baseline tricuspid regurgitation assessment. TEE-3D, mid-esophageal tricuspid valve planar view showing severe tricuspid regurgitation. B - Tricuspid regurgitation after implantation of two MitraClips (arrows) between posteroseptal (MC-PS) and anteroseptal (MC-AS). TEE-3D, mid-esophageal tricuspid valve planar view shows significant reduction of tricuspid regurgitation. C - Fluoroscopy showing position of mitral and tricuspid clips and position of pacemaker lead. D - Follow-up TEE-2D AP4C. Position of mitral and tricuspid clips
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TR (VC-2D 8 mm; VCA-3D 1.1 cm2) which was exacerbated due to the presence of a pacemaker lead causing partial posterior leaflet immobilization. The TR jet originated from both the posteroseptal and the anteroseptal coaptation line (Figure 1 A). The final TR parameters were as follows: VC-2D 4 mm; VCA-3D 0.4 cm2, mean gradient 3 mm Hg (Figure 1 B). Transthoracic echocardiography carried out on the second day following the procedure showed a very good result of placement of both mitral and tricuspid clips (Figure 1 D) with only mild MR and mild to moderate TR presence.