Author + information
- Jun Tanaka,
- Takashi Matsumoto,
- Wen Loong Yeow,
- Kenji Harada,
- Javier Berdejo,
- Kentaro Shibayama,
- Kazumasa Harada,
- Saibal Kar and
- Takahiro Shiota
Mitral valve area (MVA) decreases after MitraClip deployment. However, it may be difficult to accurately measure double orifice areas after the procedure by 2-dimensional (2D) echocardiography because orifices are located in different 2D planes (Figure, lower right). Our purpose was to determine the reduction of MVA after MitraClip using real-time 3-dimensional transesophageal echocardiography (RT3D-TEE).
We studied 53 patients who underwent RT3D-TEE during the procedure. MVA was measured before and after clip deployment with Qlab system. MVA after deployment was determined as the total area of medial and lateral area created by clip deployment (Figure).
Pre MVA was 5.19±1.25 cm2. After 1 clip deployment, MVA was 2.20±0.86 cm2 (lateral area, 1.25±0.67 cm2; medial area, 0.95±0.50 cm2). In 30 patients who had 2nd clip, mean pressure gradient increased from 2.55±0.92 mmHg to 3.68±1.47 mmHg (p=0.001), although reduction of MVA after 2nd clip was much smaller than that after 1st clip (0.39±0.19 cm2 vs. 3.22±0.88 cm2, p<0.001). There was no significant difference in the MVA reduction between functional and degenerative valve disease (p=0.54).
RT3D-TEE was useful to accurately determine the MVA not only before but also after procedure, which may be important to avoid significant mitral stenosis after clip deployment.
Figure. Mitralvalve area before and after MitraClip deployment
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Imaging: Echo: Mitral Valve Imaging/RV Function
Abstract Category: 18. Imaging: Echo
Presentation Number: 1178-314
- 2013 American College of Cardiology Foundation