Tricuspid TEER — Advanced Procedural Strategies-Use of Multi-Clip Strategy for Complex TR: How Many and Where to Place? Dr. Atushi Sugiura

Use of Multi-Clip Strategy for Complex TR: How Many and Where to Place? Dr. Atushi Sugiura

Video Transcription

Video Summary

Dr. Atushi Sugiura discussed the multi-clip strategy for complex tricuspid regurgitation (TR) repair using transcatheter edge-to-edge repair. Key considerations include optimal clip placement, number of clips, and device size based on leaflet morphology and coaptation gap location. The first clip is often placed at the antero-septal commissure to balance closure and reduce leaflet stress. Subsequent clips depend on valve anatomy, using either "zipping" (sequential clipping along the valve) or "clover" (targeting larger gaps) techniques. The zipping technique is favored for reproducibility and durability, while clover may pose risks like leaflet injury and valve gradient increase.

Keywords

multi-clip strategy

tricuspid regurgitation repair

transcatheter edge-to-edge repair

clip placement techniques

leaflet morphology