Journal: JACC Case Reports
Article Title: Combined Single-Access Left Atrial Appendage Occlusion and Transcatheter Edge-to-Edge Repair for Mitral and Tricuspid Regurgitation
doi: 10.1016/j.jaccas.2025.105085
Figure Lengend Snippet: MitraClip Implantation at the Tricuspid Valve Level (A) X-plane TEE image of first MitraClip during alignment above the tricuspid valve. (B) X-plane Color Doppler TEE image of the first MitraClip grasping the anterior and septal leaflets of the tricuspid valve. (C) Color Doppler TEE image of the deployed first MitraClip in the tricuspid position showing a significant but suboptimal reduction of the tricuspid regurgitation. (D) Fluoroscopy image of the first MitraClip deployed in the tricuspid position, clips arms closed. (E) X-plane TEE image of the second MitraClip during alignment and positioning above the tricuspid valve. (F) X-plane color Doppler TEE image of the second MitraClip grasping the anterior and septal leaflets of the tricuspid valve more centrally. (G) Color Doppler TEE image of the deployed second MitraClip in the tricuspid position showing successful reduction of the tricuspid regurgitation, with only a residual trace. (H) Fluoroscopy image of the second MitraClip being positioned at the tricuspid valve level. TEE = transesophageal echocardiography.
Article Snippet: Left atrial appendage occlusion Imaging • Transesophageal echocardiography system (Philips Healthcare) Access • Ultrasound machine (Philips Healthcare) • Radifocus Introducer II femoral, 6-F × 10 cm (Terumo Corporation) • 0.035-inch J-tip guidewire • Two ProGlide 6-F vascular closure devices (Abbott Vascular) • Amplatz Super Stiff guidewire, 0.035 inch, 260 cm (Boston Scientific) • 16-F sheath (Cook Medical) Transseptal puncture • Swartz transseptal introducer, 8.5-F (Abbott Medical) • BRK 45° transseptal needle (Abbott Medical) • TorqVue 14-F delivery system (Abbott Medical) • Pressure transduction line for intracardiac pressure monitoring LAA occlusion device • Amplatzer Amulet Left Atrial Appendage Occluder, 31 mm (Abbott Medical) Mitral transcatheter edge-to-edge repair (TEER) • 20-F dilator (Cook Medical) • MitraClip G4 system, including steerable guide catheter and clip delivery system (Abbott Structural Heart) • MitraClip G4 XTW device (Abbott Structural Heart) Tricuspid TEER • Two MitraClip G4 XTW devices (Abbott Structural Heart).
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