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Transesophageal echocardiography mitraclip

Azeem Latib, Antonio Mangieri, Eustachio Agricola, Paolo Denti, Damiano Regazzoli, Francesco Giannini, Marco B Ancona, Fabrizio Monaco, Ottavio Alfieri, Antonio Colombo
An 84-year-old man with cardial senile amyloidosis and severe tricuspid regurgitation was referred for right sided heart failure symptoms. The patient was scheduled for a percutaneous treatment due to the prohibitive risk of surgery. Two MitraClips were implanted using a transjugular approach with successful echocardiographic and clinical results. This case shows the rational of the procedural with a bicuspidalization of the valve demonstrated at the three dimensional transesophageal echocardiography.
October 17, 2016: International Journal of Cardiovascular Imaging
Azad Mashari, Ziyad Knio, Jelliffe Jeganathan, Mario Montealegre-Gallegos, Lu Yeh, Yannis Amador, Robina Matyal, Rabya Saraf, Kamal Khabbaz, Feroze Mahmood
OBJECTIVE: To evaluate the feasibility of obtaining hemodynamic metrics of echocardiographically derived 3-dimensional printed mitral valve models deployed in a pulse-duplicator chamber. DESIGN: Exploratory study. SETTING: Tertiary-care university hospital. PARTICIPANTS: Percutaneous MitraClip procedure patient. INTERVENTIONS: Three-dimensional R-wave gated, full-volume transesophageal echocardiography images were obtained after deployment of the MitraClip device...
October 2016: Journal of Cardiothoracic and Vascular Anesthesia
Jan Horstkotte, C Kloeser, H Beucher, E Schwarzlaender, R S von Bardeleben, P Boekstegers
INTRODUCTION: Intraprocedural assessment of mitral regurgitation (MR) is a challenging issue during the MitraClip procedure, which might influence not only the position but also the number of MitraClips implanted. Though transesophageal echocardiography (TEE) is the predominant tool used during the MitraClip procedure, MR assessment might be facilitated by a multimodality approach including continuous and simultaneous determination of left atrial and left ventricular (LV) pressure. METHODS: 86 consecutive patients (76...
April 1, 2016: Catheterization and Cardiovascular Interventions
Romina Murzilli, Giovanni Pedrazzini, Elena Pasotti, Tiziano Moccetti, Francesco Fulvio Faletra, Laura Anna Leo
Percutaneous edge-to-edge mitral valve repair with the MitraClip device has been shown to be a safe and effective procedure in selected patients with moderate-to-severe mitral regurgitation. Two-dimensional transesophageal echocardiography (2D TEE) is the primary imaging modality for guidance of the procedure. Real-time three-dimensional (3D) TEE has recently been used as additional imaging modality during the MitraClip procedure. In comparison with 2D TEE, 3D TEE provides additional information in several steps of the procedure, including precise positioning of the clip delivery system into the left atrium, correct alignment of the clip arms perpendicular to the coaptation line and confirmation of the correct grasping location...
October 2015: Giornale Italiano di Cardiologia
Jan Balzer, Tobias Zeus, Katharina Hellhammer, Verena Veulemans, Silke Eschenhagen, Eva Kehmeier, Christian Meyer, Tienush Rassaf, Malte Kelm
AIM: To present our initial clinical experience using this innovative software solution for guidance of percutaneous structural heart disease interventions. METHODS: Left atrial appendage, atrial septal defect and paravalvular leak closure, transaortic valve repair and MitraClip(®) procedures were performed in the catheter laboratory under fluoroscopic and echocardiographic guidance. The two-dimensional and three-dimensional images generated by the transesophageal echocardiography probe were interfaced with the fluoroscopic images in real-time using the EchoNavigator(®)-system...
September 26, 2015: World Journal of Cardiology
Mike Saji, Ann M Rossi, Gorav Ailawadi, John Dent, Michael Ragosta, D Scott Lim
OBJECTIVES: We evaluated intracardiac echocardiography (ICE) for adjunctively guiding the MitraClip procedure in patients with prior surgical rings. BACKGROUND: Transesophageal echocardiography (TEE) is the standard imaging modality used to guide the MitraClip procedure (Abbott Vascular, CA). However, in patients with post-surgical anatomy, clear imaging of the mitral valve leaflets may be complex because of shadowing from the surgical ring. In these patients, TEE may be suboptimal for guiding the procedure, even using three-dimensional imaging...
February 1, 2016: Catheterization and Cardiovascular Interventions
Lei Yu, Zhaoxia Pu, Xianbao Liu, Xiaofeng Bao, Pintong Huang, Wei He, Yan Feng, Jianjing Lin, Xiangdong You, Jian'an Wang
OBJECTIVE: To investigate the value of transesophageal echocardiography to guide the implantation of 2 pieces of MitraClip during transcatheter mitral valve repair operation. METHODS: From October 2013 to June 2014, 6 transcatheter mitral valve repair operations were performed in our hospital for symptomatic patients with severe functional mitral regurgitation (MR), transesophageal echocardiography was applied to guide the implantation of 2 pieces of MitraClip. Clinical data are retrospectively analyzed to evaluate implantation timing and approach of the 2nd piece of MitraClip, as well as the immediate effect of the interventional therapy...
April 2015: Zhonghua Xin Xue Guan Bing za Zhi
Robert Schueler, Can Öztürk, Jan Arne Wedekind, Nikos Werner, Florian Stöckigt, Fritz Mellert, Georg Nickenig, Christoph Hammerstingl
OBJECTIVES: The purpose of this study was to investigate the persistence rates of iatrogenic atrial septal defect (iASD) after interventional edge-to-edge repair with serial transesophageal echocardiography examinations and close clinical follow-up (FU). BACKGROUND: Transcatheter mitral valve repair (TMVR) with the MitraClip system (Abbott Vascular, Abbott Park, Illinois) is a therapeutic alternative to surgery in selected high-risk patients. Clip placement requires interatrial transseptal puncture and meticulous manipulation of the steerable sheath...
March 2015: JACC. Cardiovascular Interventions
Philippe Debonnaire, Victoria Delgado, Jeroen J Bax, Nina Ajmone Marsan
No abstract text is available yet for this article.
November 2014: EuroIntervention
Christiane Gruner, Bernhard Herzog, Dominique Bettex, Christian Felix, Saurabh Datta, Matthias Greutmann, Oliver Gaemperli, Simon A Müggler, Felix C Tanner, Juerg Gruenenfelder, Roberto Corti, Patric Biaggi
BACKGROUND: Echocardiographic quantification of mitral regurgitation (MR) can be challenging if the valve geometry is significantly altered. Our aim was to compare the quantification of MR by the recently developed real time three-dimensional (3D) volume color flow Doppler (RT-VCFD) method to the conventional two-dimensional (2D) echocardiographic methods during the MitraClip procedure. METHODS: Twenty-seven patients (mean age 76 ± 8 years, 56% male) were prospectively enrolled and severity of MR was assessed before and after the MitraClip procedure in the operating room by 3 different methods: (1) by integrative visual approach by transesophageal echocardiography, (2) by transthoracic 2D pulsed-wave Doppler-based calculation of aortic stroke volumes (SV) and mitral inflow allowing calculation of regurgitant volume, and (3) by transthoracic 3D RT-VCFD-based calculation of regurgitant volume...
July 2015: Echocardiography
Talea Remy, Stefan C Bertog, Nina Wunderlich, Laura Vaskelyte, Ilona Hofmann, Sameer Gafoor, Horst Sievert
BACKGROUND: MitraClip® therapy is an alternative to conventional surgery. The aim was to characterize the mitral annular geometry pre- and postrepair with the MitraClip® taking into account the regurgitation mechanism. METHODS: We retrospectively collected pre- and postprocedural transesophageal echocardiography data in 46 patients. Patients were categorized as having isolated degenerative (DMR, n = 18), isolated functional (FMR, n = 9) or a combination of both functional and degenerative mitral regurgitation (MMR, n = 19)...
October 2014: Journal of Interventional Cardiology
Takashi Matsumoto, Saibal Kar
Percutaneous edge-to-edge repair with the MitraClip system has emerged as a new therapeutic option for moderate to severe or severe mitral regurgitation (MR). Several clinical studies demonstrated its safety and efficacy in patients with both degenerative and functional MR. Based on these results, this catheter-based therapy received CE mark for both etiologies of MR in 2008, and approval from United States (US) Food and Drug Administration for degenerative MR with prohibited surgical risk in 2013. To date, around 12,000 patients underwent the MitraClip therapy worldwide...
July 2014: Kyobu Geka. the Japanese Journal of Thoracic Surgery
Michael Huntgeburth, Jochen Müller-Ehmsen, Christine Brase, Stephan Baldus, Volker Rudolph
No abstract text is available yet for this article.
September 2014: JACC. Cardiovascular Interventions
Donald D Glower, Saibal Kar, Alfredo Trento, D Scott Lim, Tanvir Bajwa, Ramon Quesada, Patrick L Whitlow, Michael J Rinaldi, Paul Grayburn, Michael J Mack, Laura Mauri, Patrick M McCarthy, Ted Feldman
BACKGROUND: The EVEREST II (Endovascular Valve Edge-to-Edge REpair STudy) High-Risk registry and REALISM Continued Access Study High-Risk Arm are prospective registries of patients who received the MitraClip device (Abbott Vascular, Santa Clara, California) for mitral regurgitation (MR) in the United States. OBJECTIVES: The purpose of this study was to report 12-month outcomes in high-risk patients treated with the percutaneous mitral valve edge-to-edge repair. METHODS: Patients with grades 3 to 4+ MR and a surgical mortality risk of ≥12%, based on the Society of Thoracic Surgeons risk calculator or the estimate of a surgeon coinvestigator following pre-specified protocol criteria, were enrolled...
July 15, 2014: Journal of the American College of Cardiology
Robert Schueler, Diana Momcilovic, Marcel Weber, Armin Welz, Nikos Werner, Cornelius Mueller, Alexander Ghanem, Georg Nickenig, Christoph Hammerstingl
BACKGROUND: Transcatheter mitral valve repair (TMVR) is a treatment option in patients with symptomatic functional or degenerative mitral regurgitation (DMR) at high surgical risk. The acute effect of MitraClip procedure on mitral valve (MV) annular geometry and its relation to functional outcomes is unclear. We sought to assess immediate effect of TMVR on MV annular geometry with 3-dimensional (3D) transesophageal echocardiography and the association of MV diameter reduction with functional response after 6 months...
June 2014: Circulation. Cardiovascular Interventions
Fabio Guarracino, Rubia Baldassarri, Baldassare Ferro, Cristina Giannini, Pietro Bertini, Anna Sonia Petronio, Vitantonio Di Bello, Giovanni Landoni, Ottavio Alfieri
The percutaneous mitral valve (MV) repair procedure performed with the MitraClip delivery system is increasingly used to treat severe mitral regurgitation in high-risk patients. The treatment involves percutaneous insertion and positioning of a clip between the MV leaflets. Transesophageal echocardiography (TEE) plays a key role in the procedure by providing information regarding clip navigation, clip alignment to the MV coaptation line, transmitral advancement of the system, leaflet grasping, confirmation of valve tissue catching, and assessment of the final result...
June 2014: Anesthesia and Analgesia
Frank van der Kley, Victoria Delgado, Nina Ajmone Marsan, Martin J Schalij
OBJECTIVES: Osteogenesis imperfecta is associated with increased prevalence of significant mitral valve regurgitation. Surgical mitral valve repair and replacement are feasible but are associated with increased risk of bleeding and dehiscence of implanted valves may occur more frequently. The present case report describes the outcomes of transcatheter mitral valve repair in a patient with osteogenesis imperfecta. PATIENTS/METHODS: A 60 year-old patient with osteogenesis imperfecta and associated symptomatic moderate to severe mitral regurgitation underwent transthoracic echocardiography which showed a nondilated left ventricle with preserved systolic function and moderate to severe mitral regurgitation...
August 2014: Heart, Lung & Circulation
Vincenzo Duino, Luigi Fiocca, Giuseppe Musumeci, Elisa Cerchierini, Mauro Gori, Emilia D'Elia, Paolo Ferrero, Attilio Iacovoni, Orazio Valsecchi, Francesco Maisano, Michele Senni, Ted Feldman, Steven Smart, Ilkay Bozdag-Turan, Stephan Kische, Liliya Paranskaya, Jasmin Ortak, Hüseyin Ince
BACKGROUND: A 71-year-old woman affected by idiopathic dilated cardiomyopathy with normal coronary arteries and permanent atrial fibrillation was found to have severe mitral regurgitation at transthoracic echocardiography (TTE), due to annular dilatation and restricted motion of the posterior leaflet. Because of poor quality of life, high functional class (NYHA Class III) and the high risk of surgery, the patient agreed to undergo the implantation of a MitraClip device. During the procedure, the transoesophageal echocardiographic (TEE) images were of a poor quality since the view of the mitral valve in the mid-oesophageal and transgastric projections did not accurately show the valve leaflets and the convergence area of the regurgitation at colour Doppler, which is indispensable for the correct positioning of the clip...
November 2014: EuroIntervention
Gian Paolo Ussia, Valeria Cammalleri, Massimo Marchei, Domenico Sergi, Pasquale De Vico, Saverio Muscoli, Kunal Sarkar, Francesco Romeo
AIMS: We sought to assess the hemodynamic sequel and the therapy adopted in patients treated with MitraClip system, who experienced a persistent interatrial communication (IAC) after the procedure. METHODS: From January 2012 to March 2013, 28 consecutive patients (mean age 74 +/- 8 years) underwent transcatheter MitraClip repair, as part of an ongoing prospective study to assess the IAC. RESULTS: Acute procedural success was 100% and a 30-days survival of 97% was reported...
April 2014: Journal of Cardiovascular Medicine
T Asdonk, G Nickenig, C Hammerstingl
Mitral regurgitation (MR) is a frequent valve disorder in elderly patients, often accompanied by multiple comorbidities such as renal impairment. In these patients percutaneous mitral valve (MV) repair has become an established treatment option but the role of MR on renal dysfunction is not yet well defined. We here report on two cases presenting with severe MR and progressive renal failure caused by cardio renal syndrome, in which percutaneous MV treatment with the MitraClip system significantly improved renal function...
October 1, 2014: Catheterization and Cardiovascular Interventions
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