Emergent Transcatheter Tricuspid Edge-to-Edge Repair for Right Ventricular Shock From Tricuspid Regurgitation in Hypertrophic Cardiomyopathy

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BACKGROUND: Transcatheter tricuspid edge-to-edge repair (T-TEER) is an emerging technology used to treat severe tricuspid regurgitation (TR). The pivotal trials demonstrating the safety and efficacy of T-TEER exclude patients with severely reduced left ventricular function (≤20%). CASE SUMMARY: We demonstrate the use of T-TEER in a patient with end-stage hypertrophic cardiomyopathy who suffered acute, torrential TR and subsequently developed cardiogenic shock as a complication of high-risk transvenous lead extraction. WHY BEYOND THE GUIDELINES: Currently, there are no guidelines addressing the nonsurgical emergent management of acute TR. DISCUSSION: The TriClip system (Abbott) may have certain advantages when used in managing acute primary TR compared with other valve repair and/or replacement approaches. TAKE-HOME MESSAGE: TriClip can be considered for urgent use to correct severe TR in hemodynamically unstable patients who are not surgical candidates.

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