Percutaneous management of tricuspid regurgitation. Image-guided step-by-step MitraClip procedure

ABSTRACT Severe tricuspid regurgitation is independently associated with an increased mortality. Recent studies show that surgery for isolated tricuspid valve (TV) is still associated with the highest surgical risk of all valve procedures. Percutaneous treatments for the management of tricuspid regurgitation have become an alternative to surgery in select patients of high surgical risk. To this day, the most widely used device is MitraClip in the tricuspid position. We reviewed the different devices used today for transcatheter treatments paying special attention to MitraClip. We describe the basic standpoints on transesophageal echocardiography screening and step-by-step procedure for the implantation of the clip. This document stands as a guide to systematize tricuspid valve assessments and the steps involved in device implantation to achieve successful procedures.