Emergent Transcatheter Tricuspid Edge-to-Edge Repair for Right Ventricular Shock From Tricuspid Regurgitation in Hypertrophic Cardiomyopathy

肥厚型心肌病三尖瓣反流引起右心室休克的紧急经导管三尖瓣缘对缘修复术

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Abstract

BACKGROUND: Transcatheter tricuspid edge-to-edge repair (T-TEER) is an emerging technology used to treat severe tricuspid regurgitation (TR). The pivotal trials demonstrating the safety and efficacy of T-TEER exclude patients with severely reduced left ventricular function (≤20%). CASE SUMMARY: We demonstrate the use of T-TEER in a patient with end-stage hypertrophic cardiomyopathy who suffered acute, torrential TR and subsequently developed cardiogenic shock as a complication of high-risk transvenous lead extraction. WHY BEYOND THE GUIDELINES: Currently, there are no guidelines addressing the nonsurgical emergent management of acute TR. DISCUSSION: The TriClip system (Abbott) may have certain advantages when used in managing acute primary TR compared with other valve repair and/or replacement approaches. TAKE-HOME MESSAGE: TriClip can be considered for urgent use to correct severe TR in hemodynamically unstable patients who are not surgical candidates.

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