Real-Time Monitoring and Step-by-Step Guidance for Transapical Mitral Valve Edge-to-Edge Repair Using Transesophageal Echocardiography

Ge, Zhenyi; Pan, Cuizhen; Li, Wei; Zhou, Daxin; Pan, Wenzhi; Wei, Lai; Chen, Haiyan; Shu, Xianhong; Ge, Junbo

doi:10.1155/2021/6659261

Cited by 3 publications

(1 citation statement)

References 25 publications

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“…Coaxiality is a common requirement for transcatheter valve implantation to avoid paravalvular leak and dislodgement ( 12 ). This is usually confirmed using two longitudinal orthogonal planes across the annular plane, which can be easily achieved for the mitral valve through the X-plane mode with the commissural view as the primary view ( 13 ). For the TV, if the abovementioned planes are insufficient to confirm coaxiality, multi-planar reconstruction can also be used ( Figures S1,S2 ).…”

Section: Adjusting the Delivery System To Align Coaxially Or Parallel...mentioning

confidence: 99%

Step-by-step transesophageal echocardiographic guidance for transjugular transcatheter tricuspid valve replacement with a radial force-independent bioprosthesis

Liu,

Li,

Zhou

et al. 2024

Quant Imaging Med Surg

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The prohibitive risk of isolated tricuspid valve (TV) surgery encouraged rapid development of a transcatheter solution for tricuspid regurgitation (TR). The favorable results of these devices informed recent guidelines to recommend considering transcatheter treatment of symptomatic secondary severe TR in inoperable patients. Transcatheter TV repair systems usually reduce TR through leaflet approximation and direct annuloplasty. Orthotopic transcatheter TV replacement (TTVR) devices generally rely on radial force and tricuspid leaflet engagement for implantation and stability. The LuX-Valve is a novel radial force-independent orthotopic TTVR device that is operated through the trans-atrial approach. Its radial force-independency is achieved through an interventricular septal anchor tab (septal insertion) and two leaflet graspers (leaflet engagement). Such a unique design makes the intraprocedural imaging different from that of other currently available TTVR systems. The latest generation of this device, the LuX-Valve Plus, comes with a newly designed delivery system through the transjugular approach, which makes the intraprocedural monitoring and adjustment of the device even more complex for successful implantation. However, its unique imaging needs for intra-procedural guidance and post-operative evaluation have not been described before. Therefore, we aimed to elaborate the key steps of transesophageal echocardiography (TEE) to guide this novel procedure. Herein, the primary 2-dimensional (2D) and 3-dimensional (3D) echocardiographic work planes are proposed and the critical steps are emphasized for better communication between imagers and interventionists. The suitability of 2D and 3D echocardiography to guide this procedure is also discussed to increase the flexibility of choice during the implantation.

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Section: Adjusting the Delivery System To Align Coaxially Or Parallel...mentioning

confidence: 99%

Step-by-step transesophageal echocardiographic guidance for transjugular transcatheter tricuspid valve replacement with a radial force-independent bioprosthesis

Liu,

Li,

Zhou

et al. 2024

Quant Imaging Med Surg

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Transcatheter edge to edge repair using the ease-of-use valve clamp system for functional mitral regurgitation: a primary report

Long

Pan

et al. 2022

Surg Today

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Clinical feasibility study of transcatheter edge-to-edge mitral valve repair in dogs with the canine V-Clamp device

Potter,

Orton,

Scansen

et al. 2024

Front. Vet. Sci.

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ObjectiveTo determine procedural feasibility, safety, and short-term efficacy in dogs with severe degenerative mitral regurgitation (MR) undergoing transcatheter edge-to-edge repair (TEER) with a canine-specific device.DesignProspective, single-arm (uncontrolled), single-institution clinical feasibility study.AnimalsFifty client-owned dogs with severe degenerative MR operated over a 28-month period.MethodsTEER was performed using the canine mitral V-Clamp via a transapical approach using transesophageal echocardiographic and fluoroscopic guidance. Indices of MR severity were determined by echocardiography the day before and 2 to 3 days after the procedure.ResultsProcedural feasibility was 96% based on delivery of at least one device in 48 of 50 dogs. There were no procedural deaths. Procedural safety was 96% based on survival to hospital discharge in 48 of 50 dogs. Euthanasia in 2 dogs prior to hospital discharge was due to damage of the mitral valve and worsened MR after the procedure. Device-related adverse event rate was 6.3% based on 3 events (single-leaflet device detachment, locking failure, locking failure with device embolization) in 59 implanted devices. All three events were nonfatal and successfully treated with a second device. Median regurgitant volume (mL/kg) decreased (p < 0.001) from 2.3 [1.9, 3.1] to 1.1 [0.3, 1.8]. Median effective regurgitant orifice area (cm2/m2) decreased (p < 0.001) from 0.60 [0.40, 0.80] to 0.25 [0.10, 0.50].Conclusion and clinical importanceInitial feasibility results support continued development of TEER as a procedurally feasible, relatively low-risk, and low morbidity treatment for degenerative MR in dogs. Operator experience and case selection are likely to be important components of success of this technique. Evidence of short-term efficacy is promising but needs to be verified with longer-term follow up.

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Real-Time Monitoring and Step-by-Step Guidance for Transapical Mitral Valve Edge-to-Edge Repair Using Transesophageal Echocardiography

Cited by 3 publications

References 25 publications

Step-by-step transesophageal echocardiographic guidance for transjugular transcatheter tricuspid valve replacement with a radial force-independent bioprosthesis

Step-by-step transesophageal echocardiographic guidance for transjugular transcatheter tricuspid valve replacement with a radial force-independent bioprosthesis

Transcatheter edge to edge repair using the ease-of-use valve clamp system for functional mitral regurgitation: a primary report

Clinical feasibility study of transcatheter edge-to-edge mitral valve repair in dogs with the canine V-Clamp device

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