Nail It with Nadira: Evolution of 3D ICE Imaging in TTVR

This case-based webinar brings together an experienced tricuspid heart team to explore the evolving role of three-dimensional intracardiac echocardiography (3D ICE) in transcatheter tricuspid interventions, including transcatheter tricuspid edge-to-edge repair (T-TEER) and transcatheter tricuspid valve replacement (TTVR). This session marks the first edition of the “Nail It with Nadira: The Radcliffe Edition” series delivered in collaboration with Radcliffe Cardiology, launching a new programme focused on practical, imaging-led approaches in structural heart interventions. The session will be moderated by Dr Nadira Hamid and will feature faculty discussion centred on the clinical use of 3D ICE imaging in contemporary tricuspid practice, reflecting current considerations around workflow optimisation, imaging strategies, and procedural efficiency. Dr Pradeep Yadav will present a TTVR case in which 3D ICE is used as a primary imaging modality, highlighting right-sided anatomy, catheter–imaging interaction, and selected intraprocedural decision points. Building on this case, Lynne Brown will review commonly used 3D ICE views (with key tips and tricks to optimize 3D imaging), measurements, and reconstructions that may support patient selection, leaflet interaction, device positioning, and assessment of residual tricuspid regurgitation. Dr Martin Swaans will discuss areas of innovation in tricuspid imaging, including fusion imaging in TTVR, advanced three-dimensional rendering, and use of artificial intelligence integration in clinical practice. The session will conclude with a panel discussion and live audience questions, addressing practical challenges encountered in clinical practice such as limited TEE windows, complex right-sided anatomy and hardware, large coaptation gaps, and multidisciplinary team training considerations. Participants will gain experience-based insights and practical perspectives on how 3D ICE may be used to support and scale tricuspid programmes in real-world settings.