Echocardiographic Evaluation of Patients Before and After MitraClip Mitral Valve Repair
Edge-to-edge mitral valve repair improves mitral leaflet coaptation and reduces mitral regurgitation (MR) by approximating the middle scallops of the mitral valve. The percutaneous transcatheter MitraClip™ system emulates edge-to-edge surgical repair. The MitraClip™ repair system has been shown to be effective in selected patients with either degenerative or functional MR. As with surgical mitral repair, the echocardiographic assessment of mitral valve anatomy and the determination of the mechanism and severity of MR are required to select appropriate patients who may benefit from percutaneous intervention and to tailor the repair strategy to the individual pathology. High quality transthoracic and transesophageal echocardiography as well as real-time 3D imaging is essential to evaluate the mitral valve for percutaneous repair, as well as to evaluate the efficacy of the repair after it has been performed. This chapter will cover the echocardiographic assessment of the mitral valve in patients who are being considered for percutaneous edge-to-edge repair, both with regard to assessing the severity of MR as well as anatomic inclusion and exclusion criteria that has been used in the US trials and outside the US clinically. It will also cover the echocardiographic assessment of patients following percutaneous edge-to-edge mitral repair.
KeywordsEchocardiography Real time 3D TEE Mitral regurgitation Mitral regurgitation severity Mitraclip Degenerative MR Functional MR Regurgitant orifice are Regurgitant volume Percutaneous mitral repair Residual MR Mitral stenosis
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