Quantification of Mitral Regurgitation During Percutaneous Mitral Valve Repair: Added Value of Simultaneous Hemodynamic and 3D Echocardiographic Assessment

Overview

Journal Int J Cardiovasc Imaging

Publisher Springer

Specialty Radiology

Date 2017 May 13

PMID 28497189

Citations 1

Authors

Ilonka Rohm

Tudor C Poerner

Ali Hamadanchi

Sylvia Otto

Torsten Doenst

Christian Jung

P Christian Schulze

Bjorn Goebel

Affiliations

Soon will be listed here.

Abstract

The objective of this study was to investigate the usefulness of intraprocedural hemodynamic monitoring for MR evaluation during pMRV. Assessment of mitral regurgitation (MR) during percutaneous mitral valve repair (pMVR) procedure is challenging. 3D color Doppler allows exact quantification of MR, but is technically demanding. Sixty patients with moderate to severe MR (14 with structural and 46 functional MR) were included in the study. Intraprocedural pressure curves were continuously obtained in the left atrium (LA) and left ventricle (LV). Transesophageal echocardiography was performed using 3D color Doppler derived mean vena contracta area (VCA) and mitral regurgitation volume (RegVol) to quantify MR severity before and after each clip implantation. In the entire patient group, strongest correlations were observed firstly between VCA and the raise of the ascending limb of the left atrial V pressure wave (V; r = 0.58, p < 0.001) and secondly between the difference of peak V wave pressure and mean LA pressure divided by systolic LV pressure [(V - LA) - LV; r = 0.53, p < 0.001]. In patients with structural MR, the highest area under the ROC curve for prediction of mild MR (VCA < 0.2 cm² and RegVol < 30 ml) after clip implantation was found for V (AUC 0.89, p < 0.001) whereas in functional MR calculation of (V - LA) - LV showed the highest predictive value (AUC 0.69, p = 0.003). Invasive pressure monitoring can give a direct feedback with regard to the success of clip placement during pMVR.

Citing Articles

Impact of different annuloplasty rings on geometry of the mitral annulus with fibroelastic deficiency: the significance of aorto-mitral angle.

Ma W, Ye W, Zhang J, Zhang W, Wu W, Kong Y Int J Cardiovasc Imaging. 2018; 34(11):1707-1713.

PMID: 29845584 DOI: 10.1007/s10554-018-1383-4.

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