BACKGROUND: The aim of this study was to quantify the acute dynamic changes of mitral valve (MV) geometry throughout the cardiac cycle-during percutaneous MV repair with the MitraClip system by 3-dimensional transesophageal echocardiography (3D TEE). METHODS: The MV was imaged throughout the cardiac cycle (CC) before and after the MitraClip procedure using 3D TEE in 28 patients (mean age, 77 ± 8 years) with functional mitral regurgitation (FMR). Dynamic changes in the MV annulus geometry and anatomical MV orifice area (AMVOA) were quantified using a novel semi-automated software. RESULTS: Percutaneous MV repair decreased anterior-posterior diameter by up to 9% (at 50% of CC; from 34.5 to 31.9 mm; p < 0.001) throughout the CC and increased the diastolic lateral-medial diameter by up to 7% (at 60% of the CC; from 39.7 to 42.3 mm; p < 0.001), whereas the annular circumference and area were not significantly affected. Annulus sphericity index was reduced up to 13% (at 50% of the CC; from 0.89 to 0.78, p < 0.001). The AMVOA also decreased during systole, the maximum decrease being from 0.6 to 0.2 mm2 (at 0% of CC; p = 0.007), and during diastole the maximum decrease being from 4.6 to 1.6 cm2 (at 50% of CC; p < 0.001). CONCLUSIONS: Percutaneous MV repair reduces the MR by an improved coaptation of MV leaflets joint with a simultaneous indirect reduction of anterior-posterior diameter. Further, the MitraClip procedure leads to a reduction of AMVOA of more than 60% during diastole.
BACKGROUND: The aim of this study was to quantify the acute dynamic changes of mitral valve (MV) geometry throughout the cardiac cycle-during percutaneous MV repair with the MitraClip system by 3-dimensional transesophageal echocardiography (3D TEE). METHODS: The MV was imaged throughout the cardiac cycle (CC) before and after the MitraClip procedure using 3D TEE in 28 patients (mean age, 77 ± 8 years) with functional mitral regurgitation (FMR). Dynamic changes in the MV annulus geometry and anatomical MV orifice area (AMVOA) were quantified using a novel semi-automated software. RESULTS: Percutaneous MV repair decreased anterior-posterior diameter by up to 9% (at 50% of CC; from 34.5 to 31.9 mm; p < 0.001) throughout the CC and increased the diastolic lateral-medial diameter by up to 7% (at 60% of the CC; from 39.7 to 42.3 mm; p < 0.001), whereas the annular circumference and area were not significantly affected. Annulus sphericity index was reduced up to 13% (at 50% of the CC; from 0.89 to 0.78, p < 0.001). The AMVOA also decreased during systole, the maximum decrease being from 0.6 to 0.2 mm2 (at 0% of CC; p = 0.007), and during diastole the maximum decrease being from 4.6 to 1.6 cm2 (at 50% of CC; p < 0.001). CONCLUSIONS: Percutaneous MV repair reduces the MR by an improved coaptation of MV leaflets joint with a simultaneous indirect reduction of anterior-posterior diameter. Further, the MitraClip procedure leads to a reduction of AMVOA of more than 60% during diastole.
Entities:
Keywords:
3D echocardiography; MitraClip; Mitral regurgitation; Mitral valve geometry
Authors: P Boekstegers; J Hausleiter; S Baldus; R S von Bardeleben; H Beucher; C Butter; O Franzen; R Hoffmann; H Ince; K H Kuck; V Rudolph; U Schäfer; W Schillinger; N Wunderlich Journal: Clin Res Cardiol Date: 2014-02 Impact factor: 5.460
Authors: Patrizio Lancellotti; Luis Moura; Luc A Pierard; Eustachio Agricola; Bogdan A Popescu; Christophe Tribouilloy; Andreas Hagendorff; Jean-Luc Monin; Luigi Badano; Jose L Zamorano Journal: Eur J Echocardiogr Date: 2010-05
Authors: Francesco Maisano; Olaf Franzen; Stephan Baldus; Ulrich Schäfer; Jörg Hausleiter; Christian Butter; Gian Paolo Ussia; Horst Sievert; Gert Richardt; Julian D Widder; Tiziano Moccetti; Wolfgang Schillinger Journal: J Am Coll Cardiol Date: 2013-06-07 Impact factor: 24.094
Authors: Ted Feldman; Elyse Foster; Donald D Glower; Donald G Glower; Saibal Kar; Michael J Rinaldi; Peter S Fail; Richard W Smalling; Robert Siegel; Geoffrey A Rose; Eric Engeron; Catalin Loghin; Alfredo Trento; Eric R Skipper; Tommy Fudge; George V Letsou; Joseph M Massaro; Laura Mauri Journal: N Engl J Med Date: 2011-04-04 Impact factor: 91.245
Authors: Frank Patrick Schmidt; Ralph Stephan von Bardeleben; Philipp Nikolai; Alexander Jabs; Nina Wunderlich; Thomas Münzel; Ulrich Hink; Ascan Warnholtz Journal: Eur Heart J Cardiovasc Imaging Date: 2013-01-02 Impact factor: 6.875
Authors: Alec Vahanian; Ottavio Alfieri; Felicita Andreotti; Manuel J Antunes; Gonzalo Barón-Esquivias; Helmut Baumgartner; Michael Andrew Borger; Thierry P Carrel; Michele De Bonis; Arturo Evangelista; Volkmar Falk; Bernard Lung; Patrizio Lancellotti; Luc Pierard; Susanna Price; Hans-Joachim Schäfers; Gerhard Schuler; Janina Stepinska; Karl Swedberg; Johanna Takkenberg; Ulrich Otto Von Oppell; Stephan Windecker; Jose Luis Zamorano; Marian Zembala Journal: Eur J Cardiothorac Surg Date: 2012-08-25 Impact factor: 4.191
Authors: Ted Feldman; Saibal Kar; Michael Rinaldi; Peter Fail; James Hermiller; Richard Smalling; Patrick L Whitlow; William Gray; Reginald Low; Howard C Herrmann; Scott Lim; Elyse Foster; Donald Glower Journal: J Am Coll Cardiol Date: 2009-08-18 Impact factor: 24.094
Authors: Alberto Alperi; Pablo Avanzas; Isaac Pascual; Antonio Adeba; Rebeca Lorca; Victor León; Marcel Almendarez; Hector Cubero-Gallego; Iria Silva-Conde; César Moris; Daniel Hernandez-Vaquero Journal: Ann Transl Med Date: 2020-08