Effective 3 Leaflet Grasping During TriClip Procedure: The “3-Point” Buzzer Beater

An 80-year-old man with severe tricuspid regurgitation (Video Series) and a longstanding history of atrial fibrillation was referred to our center to undergo percutaneous tricuspid valve repair due to persistent peripheral edema that was not controlled by medical therapy.

Under transesophageal echocardiography guidance, we attempted to grasp the anterior and septal leaflets. However, grasping was not initially successful. The clip was moved and deployed centrally, spanning the septal leaflet on one side and anterior and posterior leaflets close to the anteroposterior commissure on the other (Figure 1). Tissue grasping was checked and confirmed. Excellent final result was obtained with triple orifice creation (Figure 2) and mild residual regurgitation (Video Series).

To the best of our knowledge, this is the first report of simultaneous grasping of the 3 leaflets during TriClip (Abbott Cardiovascular) implantation. The final valve configuration with a triple orifice (Figure 3) resembled the result of the clover surgical technique. This technique should be considered in selected cases of challenging grasping.

Affiliations and Disclosures

From GVM Care and Research, Maria Cecilia Hospital, Cotignola, Italy.

Disclosure: The authors have completed and returned the ICMJE Form for Disclosure of Potential Conflicts of Interest. The authors report no conflicts of interest regarding the content herein.

The authors report that patient consent was provided for publication of the images used herein.

Manuscript accepted March 25, 2022.

Address for correspondence: Roberto Nerla, MD, Maria Cecilia Hospital, Via Corriera 1, 48033 Cotignola RA, Italy. Email: robertonerla83@gmail.com

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