BACKGROUND: Postprocedural mitral stenosis (MS), or increased transmitral mean pressure gradient (TMPG), is one of the limitations of transcatheter edge-to-edge mitral valve repair using MitraClip (Abbott Vascular Inc., Santa Clara, USA); however, the usefulness of three-dimensional transesophageal echocardiography (3D-TEE) for predicting postprocedural MS in functional mitral regurgitation (MR) has not been fully elucidated. METHODS: Eighty-two consecutive functional MR patients who underwent transcatheter mitral valve repair using MitraClip were retrospectively studied. Postprocedural MS was defined as TMPG ≥ 5 mmHg by echocardiography. RESULTS: Ten patients had postprocedural MS, and 3D-TEE showed that patients with postprocedural MS had smaller preprocedural mitral valve orifice area (MVOA), anteroposterior and mediolateral diameter, leaflet area, and annulus area. Receiver operating characteristic analysis showed that leaflet area (area under the curve (AUC) 0.829), annulus area (AUC 0.813), anteroposterior diameter (AUC 0.797) and mediolateral diameter (AUC 0.803) evaluated using 3D-TEE were predictors of postprocedural MS, and their predictive abilities were higher than those of preprocedural MVOA (AUC 0.756) and preprocedural TMPG (AUC 0.716). Adding leaflet area to TMPG and MVOA resulted in higher C-statistics for predicting postprocedural MS (from 0.716 to 0.845 and from 0.756 to 0.853, respectively). CONCLUSIONS: In functional MR patients treated with MitraClip, leaflet area and annulus area evaluated using 3D-TEE had high predictive values for postprocedural MS, and their predictive abilities were higher than those of preprocedural TMPG or MVOA.
BACKGROUND: Postprocedural mitral stenosis (MS), or increased transmitral mean pressure gradient (TMPG), is one of the limitations of transcatheter edge-to-edge mitral valve repair using MitraClip (Abbott Vascular Inc., Santa Clara, USA); however, the usefulness of three-dimensional transesophageal echocardiography (3D-TEE) for predicting postprocedural MS in functional mitral regurgitation (MR) has not been fully elucidated. METHODS: Eighty-two consecutive functional MR patients who underwent transcatheter mitral valve repair using MitraClip were retrospectively studied. Postprocedural MS was defined as TMPG ≥ 5 mmHg by echocardiography. RESULTS: Ten patients had postprocedural MS, and 3D-TEE showed that patients with postprocedural MS had smaller preprocedural mitral valve orifice area (MVOA), anteroposterior and mediolateral diameter, leaflet area, and annulus area. Receiver operating characteristic analysis showed that leaflet area (area under the curve (AUC) 0.829), annulus area (AUC 0.813), anteroposterior diameter (AUC 0.797) and mediolateral diameter (AUC 0.803) evaluated using 3D-TEE were predictors of postprocedural MS, and their predictive abilities were higher than those of preprocedural MVOA (AUC 0.756) and preprocedural TMPG (AUC 0.716). Adding leaflet area to TMPG and MVOA resulted in higher C-statistics for predicting postprocedural MS (from 0.716 to 0.845 and from 0.756 to 0.853, respectively). CONCLUSIONS: In functional MR patients treated with MitraClip, leaflet area and annulus area evaluated using 3D-TEE had high predictive values for postprocedural MS, and their predictive abilities were higher than those of preprocedural TMPG or MVOA.
Authors: Patric Biaggi; Sean Jedrzkiewicz; Christiane Gruner; Massimiliano Meineri; Jacek Karski; Annette Vegas; Felix C Tanner; Harry Rakowski; Joan Ivanov; Tirone E David; Anna Woo Journal: J Am Soc Echocardiogr Date: 2012-04-24 Impact factor: 5.251
Authors: Edith Lubos; Michael Schlüter; Eik Vettorazzi; Britta Goldmann; Daniel Lubs; Johannes Schirmer; Hendrik Treede; Hermann Reichenspurner; Stefan Blankenberg; Stephan Baldus; Volker Rudolph Journal: JACC Cardiovasc Interv Date: 2014-03-14 Impact factor: 11.195
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: Gregg W Stone; JoAnn Lindenfeld; William T Abraham; Saibal Kar; D Scott Lim; Jacob M Mishell; Brian Whisenant; Paul A Grayburn; Michael Rinaldi; Samir R Kapadia; Vivek Rajagopal; Ian J Sarembock; Andreas Brieke; Steven O Marx; David J Cohen; Neil J Weissman; Michael J Mack Journal: N Engl J Med Date: 2018-09-23 Impact factor: 91.245