Underestimation of Intraprocedural Tricuspid Valve Pressure Gradient by Echocardiography in Patients Undergoing Tricuspid Transcatheter Edge-to-Edge Repair.

performed as a new therapy to treat symptomatic high-risk patients with significant TR. This technique has been shown to be safe and effective.2,3 Clipping the tricuspid valve leaflets improves TR by enhancing leaflet coaptation. However, iatrogenic tricuspid stenosis may occur, which is indicated by an elevated tricuspid valve pressure gradient (TVPG). Previous studies arbitrarily have proposed a TVPG of <3 mmHg as an acceptable gradient after clipping.4,5 However, limited data on the relationship between intra-procedural and post-procedural TVPG are available. Considering that the venous return tends to decrease during general anesthesia,6,7 we hypothesized that TVPG might be underestimated during the procedure. Here, we compared the TVPG values measured by intraprocedural