Hemodynamic guidance of mitral paravalvular leak closure: The <scp>V</scp> is the key

Goldstein, James A.

doi:10.1002/ccd.27355

Cited by 1 publication

(1 citation statement)

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“…In response to the limitations of echocardiographic assessment in the real‐time monitoring of transcatheter paravalvular leak closure, simultaneous invasive hemodynamic has evolved as a complementary tool. At the onset of leak closure, this assessment often discloses first an elevated LA v‐wave pressure, reflecting—independent of echocardiographic findings—the severity of suspected mitral regurgitation, changes in LA compliance, and elevations in intracardiac pressure . These elevations in pressure are in turn transmitted to the pulmonary vasculature, contributing to clinical symptoms in the process.…”

Section: Transcatheter Mitral Valve Interventionmentioning

confidence: 99%

Hemodynamics rounds: Hemodynamics of mitral valve interventions

Lloyd

Rihal

Eleid

2020

Cathet Cardio Intervent

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Mitral valvulopathy presents as regurgitation, stenosis, or mixed disease and can occur in both native and prosthetic valves. Such disease develops in conjunction with pathophysiologic changes in the left atrium (LA) and drives changes in LA compliance, pressure, and thus clinical syndromes. With advances in the understanding and treatment of structural heart disease and in the setting of higher‐risk patient populations, less‐invasive transcatheter approaches have become increasingly commonplace in the treatment of mitral valve disease. Over time, transcatheter mitral valve interventions have evolved to include paravalvular leak closure, mitral valve repair, and mitral valve replacement. Parallel to this evolution, advances in invasive intracardiac pressure monitoring, particularly at the level of the LA, have also occurred. These advances emphasize the unique interplay between mitral valve disease and LA function; account for limitations of noninvasive assessment; and guide beneficial outcomes in each area of transcatheter mitral valve intervention. As a result, continuous transseptal LA pressure monitoring has developed into an indispensable instrument in successful percutaneous mitral valve intervention, complementing traditional noninvasive assessment.

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Section: Transcatheter Mitral Valve Interventionmentioning

confidence: 99%