WASHINGTON—The Society for Cardiovascular Angiography & Interventions (SCAI) has published a first-of-its-kind educational resource for interventional cardiologists and imaging specialists performing Transcatheter Tricuspid Edge-to-Edge Repair (T-TEER).
This freely accessible eBook is a comprehensive procedural guide to T-TEER, a groundbreaking minimally invasive therapy for tricuspid regurgitation (TR). Developed by leading experts in the field, the eBook provides step-by-step procedural guidance, patient selection criteria, imaging protocols, and best practices for achieving optimal patient outcomes.
"There are currently no textbooks on this procedure. This eBook is not just a guide—it’s the first major publication dedicated to T-TEER best practices," said co-author Jason H. Rogers, MD, FSCAI, Professor of Cardiovascular Medicine and Director of the Interventional and Structural Cardiology Fellowship Programs at the University of California Davis Medical Center. "By gathering insights from experts who pioneered this procedure in Europe and North America, we have created a comprehensive roadmap for safe and effective adoption of this therapy worldwide. We wanted to ensure that every interventionalist, regardless of location or resources, has access to the best information possible."
Bridging the Knowledge Gap in Tricuspid Valve Repair
Until recently, tricuspid regurgitation (TR)—often referred to as the “forgotten valve disease”—had limited treatment options, as surgical repair or replacement posed high risks for most patients. However, the FDA approval of T-TEER in 2024, based on the TRILUMINATE trial, has ushered in a new era of minimally invasive therapy for patients with severe TR.
"T-TEER is an exciting advancement for patients with severe tricuspid regurgitation. On the clinical side, its adoption requires a strong foundation in imaging, anatomy, and procedural technique. This eBook provides a structured approach to mastering this procedure, providing a structured, practical resource for clinicians to ensure they can rapidly adopt best practices and improve patient outcomes,” said co-author Anita Asgar, MD, MSc, FSCAI, Chief of Interventional Cardiology at the Bluhm Cardiovascular Institute at Northwestern Medicine. "The eBook provides clear guidance on patient selection, procedural strategies, and troubleshooting. By gathering insights from global leaders in tricuspid repair, we hope to accelerate learning, shorten the procedural learning curve, and ultimately improve patient outcomes worldwide.”
The T-TEER eBook capitalizes on the success of Drs. Asgar and Rogers’ Mitral TEER eBook, which has been downloaded over 10,000 times worldwide and translated into multiple languages. Crucially, the new T-TEER resource adds coauthor Rhonda Miyasaka, MD, a cardiologist at the Cleveland Clinic specializing in cardiovascular imaging. Dr. Miyasaka played a key role in developing the eBook’s imaging content, given that advanced echocardiography is essential to procedural success.
"One of the biggest challenges in tricuspid interventions is imaging," Dr. Miyasaka said. “Imaging is the foundation of a successful T-TEER procedure, yet the tricuspid valve presents unique visualization challenges that require specialized techniques. From preprocedural planning and real-time guidance, the eBook provides a clear, practical guide to transthoracic and transesophageal echocardiographic imaging to help clinicians optimize visualization, device positioning, and procedural outcomes. By equipping interventionalists and echocardiographers with the knowledge to optimize imaging, we aim to improve procedural success rates and ensure the best possible outcomes for patients undergoing T-TEER."
Key Features of the T-TEER eBook
T-TEER presents unique challenges that necessitate a dedicated resource, including:
- More complex anatomy: The tricuspid valve has three leaflets instead of two, making clip placement significantly more intricate.
- Challenging imaging requirements: The tricuspid valve is farther from the echocardiographic probe, making visualization more difficult than with the mitral valve.
- Interaction with existing devices: Many TR patients have pacemaker or ICD leads that can obstruct access to the tricuspid valve.
The T-TEER eBook serves as a practical, step-by-step resource for clinicians performing this novel procedure, featuring:
- Patient Selection & Indications – Guidelines on selecting ideal candidates for T-TEER and understanding contraindications.
- Step-by-Step Procedural Techniques – A structured approach to clip placement, leaflet grasping, and troubleshooting.
- Advanced Imaging Guidance – Detailed echocardiographic techniques for optimal visualization and procedural success.
- Managing Complications – Strategies for handling device embolization, leaflet injury, and pacemaker interference.
- Video Case Studies – Real-world examples demonstrating successful T-TEER procedures with expert commentary.
The T-TEER eBook was made possible through an educational grant from Abbott, whose TriClip™ device was the first transcatheter therapy for TR to receive FDA approval.
How to Access the eBook
The T-TEER eBook is available as a freely accessible download on the SCAI website at https://scaipro.scai.org/URL/TricuspidTEEReBook
Media Contact: Gavin Stern gstern@scai.org
About SCAI: The Society for Cardiovascular Angiography and Interventions is a professional organization representing more than 5,000 invasive and interventional cardiology professionals in approximately 75 nations. SCAI's mission is to promote excellence in invasive/interventional cardiovascular medicine through physician education and representation, and advancement of quality standards to enhance patient care. www.scai.org