Novel Percutaneous Techniques for Mitral and Tricuspid Valve Repair

Percutaneous valve interventions are a viable alternative for many patients considered to be high surgical risk. Transcatheter technologies to treat mitral and tricuspid regurgitation are rapidly evolving and include devices for leaflet repair, annular reduction, and valve replacement. 3D echocardiography (3DE) and in particular 3D transesophageal echocardiography (3D TEE) have a pivotal role in the planning and guiding of these interventions. Enface views of the mitral and tricuspid valves with 3DE provide crucial information regarding the mechanism(s) of MR and TR, and catheters and devices are better seen in the 3D space than in the 2D tomographic space. As with any percutaneous intervention, a thorough knowledge of all steps of the procedure including the devices, wires and catheters/sheaths used is a prerequisite to guide these interventions. Nonetheless, Imaging can be very challenging, and this is compounded by the myriad of emerging technologies.