Interest in transcatheter treatment of tricuspid regurgitation (TR) has grown significantly in recent years due to increasing evidence correlating TR severity with mortality and to limited availability of surgical options often considered high-risk in these patients. Although edge-to-edge repair is currently the main transcatheter therapeutic strategy, tricuspid valve direct annuloplasty can also be performed safely and effectively to reduce TR and improve heart failure symptoms and quality of life. In the annuloplasty procedure, an adjustable band is implanted around the tricuspid annulus to reduce valvular size and improve TR. Patient selection and careful preoperative imaging, including transthoracic echocardiography, transesophageal echocardiography, and computed tomography, are critical for procedural success and proper device implantation. Compared to edge-to-edge repair, perioperative imaging with transesophageal echocardiography and fluoroscopy is particularly challenging. Alignment and insertion of the anchors are demanding but essential to achieve good results and avoid damaging the surrounding structures. The presence of shadowing artifacts due to cardiac devices makes the acquisition of good-quality images even more challenging. In this review, we discuss the current role of multimodality imaging in planning direct transcatheter tricuspid valve annuloplasty and describe all procedural steps focusing on echocardiographic monitoring.

中文翻译：

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用于规划和指导直接经导管三尖瓣瓣环成形术的多模态成像方法

近年来，人们对经导管治疗三尖瓣反流 (TR) 的兴趣显着增长，因为越来越多的证据表明 TR 严重程度与死亡率相关，而且这些患者通常被认为是高风险的手术选择有限。虽然边对边修复是目前主要的经导管治疗策略，但三尖瓣直接瓣环成形术也可以安全有效地进行，以减少TR并改善心力衰竭症状和生活质量。在瓣环成形术中，可调节带植入三尖瓣环周围，以减小瓣膜尺寸并改善 TR。患者选择和仔细的术前成像，包括经胸超声心动图、经食管超声心动图和计算机断层扫描，对于手术成功和正确的装置植入至关重要。与边到边修复相比，经食管超声心动图和透视检查的围手术期成像尤其具有挑战性。锚栓的对齐和插入要求很高，但对于获得良好效果并避免损坏周围结构至关重要。心脏设备导致的阴影伪影的存在使得获取高质量图像变得更加困难。在这篇综述中，我们讨论了多模态成像在计划直接经导管三尖瓣瓣环成形术中的当前作用，并描述了重点关注超声心动图监测的所有程序步骤。