System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

Case Reports Journal Article Ahead of print

PubMed: 41824611 DOI: 10.1016/j.jaccas.2026.107346

Isolated Transcatheter Tricuspid Valve Edge-to-Edge Repair in Repaired Tetralogy of Fallot.

JACC Case Rep

Authors: Omar Azizi, Zakaria Jalal, Julien Ternacle, Lionel Leroux, Jean-Benoit Thambo, Xavier Iriart

Affiliations

  • Department of Pediatric and Congenital Cardiology, National Reference Center for Complex Congenital Heart Disease, Hôpital Cardiologique du Haut-Lévêque and the Université Victor Segalen Bordeaux II, Bordeaux, France.
  • Department of Pediatric and Congenital Cardiology, National Reference Center for Complex Congenital Heart Disease, Hôpital Cardiologique du Haut-Lévêque and the Université Victor Segalen Bordeaux II, Bordeaux, France.
  • Medical-Surgical Department of Valvular Heart Disease and Cardiomyopathies, Hôpital Cardiologique du Haut-Lévêque and the Université Victor Segalen Bordeaux II, Bordeaux, France.

Abstract

BACKGROUND

Adults with repaired tetralogy of Fallot (rTOF) frequently develop right heart failure, most commonly related to pulmonary regurgitation. Tricuspid regurgitation (TR) is an underrecognized contributor. Transcatheter edge-to-edge repair (TEER) has emerged as an alternative to surgery, but evidence in congenital heart disease remains limited.

CASE SUMMARY

We report the first case of isolated tricuspid valve repair using TriClip in an adult with rTOF and severe symptomatic TR. Preprocedural transesophageal echocardiography demonstrated type IIIb anatomy with a 6-mm coaptation gap. The initial clip entrapment resulted in chordal rupture and transient TR worsening. Two additional clips were successfully implanted, leading to significant TR reduction and clinical improvement.

DISCUSSION

This case highlights both the feasibility and technical challenges of TEER in complex congenital anatomy.

TAKE-HOME MESSAGES

TR contributes to right heart failure in rTOF. The tricuspid subvalvular apparatus may be fragile; nevertheless, TEER remains feasible and clinically beneficial in selected patients.

MeSH

Heart Defects, Congenital, Tetralogy Of Fallot, Heart Failure, Heart, Cardiovascular Diseases, Tricuspid Valve, Papillary Muscles, Tricuspid Valve Insufficiency, Anatomy