Document Detail


Value of color Doppler three-dimensional transesophageal echocardiography in the percutaneous closure of mitral prosthesis paravalvular leak.
MedLine Citation:
PMID:  20346317     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We investigated the clinical value of three-dimensional (3D) transesophageal echocardiography (TEE) color flow Doppler (TEE-CFD) for percutaneous transcatheter closure of mitral valve prosthesis paravalvular leaks (PVLs) compared to two-dimensional (2D) TEE. The number, location, and size of the mitral valve prosthesis PVLs were determined in 8 patients using 2D and 3D TEE-CFD. We also evaluated 2D and 3D TEE-CFD for identifying the canalization of the target PVL during the intervention and assessing the change in the PVL effective orifice after the endovascular procedure. We visualized 12 PVLs using 2D TEE-CFD and 15 PVLs using 3D TEE-CFD. No substantial disagreement was found between 2D and 3D TEE-CFD for the location for each of the PVLs. No difference was found in the vena contracta short axis width obtained by 2D TEE-CFD and 3D TEE-CFD (5.7 +/- 1.4 mm vs 5.5 +/- 1.3 mm, respectively, p = 0.09). However, only 3D TEE-CFD demonstrated the effective circumferential orifice length of the PVL (12.2 +/- 8.5 mm). A closure device was deployed in 6 cases. In 1 case, the canalization of a nontarget PVL, visualized only on 3D TEE-CFD, led to an appropriate change in the treatment strategy. The reduction in the mean PVL vena contracta width demonstrated using 2D TEE-CFD and 3D TEE-CFD was similar (2.2 +/- 0.7 mm vs 2.1 +/- 1.1 mm, respectively, p = 0.69). However, only 3D TEE-CFD verified the reduction of the effective orifice circumferential length of the PVL by 10.5 +/- 5.6 mm. In conclusion, 3D TEE-CFD provided unique and additive information in patients with mitral valve prosthesis PVLs. This new technology has the potential to improve the procedural success of percutaneous transcatheter closure of PVLs.
Authors:
Simon Biner; Saibal Kar; Robert J Siegel; Asim Rafique; Takahiro Shiota
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2010-02-13
Journal Detail:
Title:  The American journal of cardiology     Volume:  105     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-29     Completed Date:  2010-04-15     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  984-9     Citation Subset:  AIM; IM    
Copyright Information:
Copyright 2010. Published by Elsevier Inc.
Affiliation:
Division of Cardiology, Cedars-Sinai Medical Center, and David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
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MeSH Terms
Descriptor/Qualifier:
Anemia, Hemolytic / etiology
Echocardiography, Doppler, Color*
Echocardiography, Three-Dimensional*
Echocardiography, Transesophageal*
Heart Failure / etiology
Heart Valve Prosthesis* / adverse effects
Humans
Mitral Valve*
Prosthesis Failure*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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