Document Detail


Analysis of Procedural Effects of Percutaneous Edge-to-Edge Mitral Valve Repair by 2D and 3D Echocardiography.
MedLine Citation:
PMID:  23001897     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: -Analysis of procedural effects in patients undergoing percutaneous mitral valve edge-to-edge repair (PMVR) is complex and common techniques to define mitral regurgitation severity based on 2-dimensional (2D) echocardiography are not validated for post procedural double-orifice mitral valve. This study used 3-dimensional (3D) transesophageal echocardiography (TEE) to determine functional and morphological effects of PMVR METHODS AND RESULTS: -In 39 high-surgical risk patients with moderate to severe functional mitral valve regurgitation 3D TEE with and without color Doppler as well as 2D transthoracic and transesophageal echocardiography was performed before and after PMVR (MitraClip™ device). Mitral valve regurgitant volume (RV) by color Doppler 3D TEE was determined as the product of vena contracta areas defined by direct planimetry and velocity time integral using CW Doppler. RV was reduced from 84.1±38.3 ml pre intervention to 35.6±25.6 ml post intervention. Patients in whom vena contracta area could be reduced >50% had a smaller pre procedural mitral annulus area compared to patients with ≤50% reduction (11.9±3.9 vs. 16.1±8.5 cm(2), respectively; p=0.036) and tended to have a smaller mitral annulus circumference (13.0±2.0 vs. 14.8±4.1 cm, respectively; p=0.112). At 6 months follow-up left atrial and left ventricular end-diastolic volumes were significantly more reduced in patients in whom regurgitant vena contracta area was reduced by >50% compared to those with less reduction (-11.4±5.2 vs. -4.8±7.7%; p=0.005, and -11.0±7.2 vs. -4.5±9.3%; p=0.028). The maximum diastolic mitral valve area decreased from 6.0±2.0 to 2.9±0.9 cm(2) (p<0.0001). CONCLUSIONS: -3D transesophageal echocardiography demonstrates significant reduction of regurgitant volume after PMVR. The unique visualization of the mitral valve by 3D TEE allows improved understanding of the morphological and functional changes induced by PMVR.
Authors:
Ertunc Altiok; Sandra Hamada; Kathrin Brehmer; Kathrin Kuhr; Sebastian Reith; Michael Becker; Jörg Schröder; Mohammad Almalla; Walter Lehmacher; Nikolaus Marx; Rainer Hoffmann
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-9-21
Journal Detail:
Title:  Circulation. Cardiovascular imaging     Volume:  -     ISSN:  1942-0080     ISO Abbreviation:  Circ Cardiovasc Imaging     Publication Date:  2012 Sep 
Date Detail:
Created Date:  2012-9-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101479935     Medline TA:  Circ Cardiovasc Imaging     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
1 University Hospital RWTH Aachen, Germany;
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