Assessment of mitral valve area by 3D planimetry after percutaneous mitral valve repair. (14th October 2021)

• Record Type: Journal Article
• Authors: Gordillo, X; Pozo Osinalde, E; Salinas Gallegos, A; Jimenez Quevedo, P; Marcos-Alberca, P; Mahia, P; Tirado, G; Perez De Isla, L; Macaya, C; Perez-Villacastin, J; Fernandez-Ortiz, A; Nombela-Franco, L; De Agustin, J A
• Is Part Of: European heart journal. Volume 42(2021)Supplement 1
• Publication Date: 2021-10-14
• Subjects: Valvular Heart Disease; Cardiology -- Periodicals; Heart -- Diseases -- Periodicals; 616.12005
• DOI: 10.1093/eurheartj/ehab724.0127
• Languages: English
• ISSNs: 0195-668X

Abstract

Abstract: Background: Percutaneous mitral valve (MV) repair has become an effective therapeutic alternative to MV surgery in high-risk surgical patients with severe MR. Persistent pulmonary hypertension after mitral valve replacement has shown an increased risk of morbidity and mortality. Improvement of pulmonary systolic arterial pressure (PSAP) post-MitraClip has been reported, however relative mitral stenosis may hamper this benefit. Few data is available regarding the best echocardiographic parameter to determine mitral stenosis after the procedure. Purpose: To evaluate the correlation between the residual mitral valve area (MVA) by 3D planimetry, the pressure half time (PHT) and the transmitral gradient after percutaneous edge-to-edge mitral repair. Methods: This is a single-center, retrospective study. We enrolled 88 consecutive patients who underwent a percutaneous MV repair with the MitraClip system between 2010 and 2020 at our tertiary university hospital, with eligibility evaluation by transesophageal echocardiogram (TEE). All patients had moderate to severe (3+) or severe (4+) primary or secondary MR. Results: The mean age was 76.2±10.4 years and 64.8% of the patients were male. Above 88% of patients were in New York Heart Association class III/IV. Baseline 3D planimetry MVA was 5.3±1.4cm 2 and mean gradient pre-implantation was 1.8±0.8mmHg. After the procedure, MVA reduced to 2.9±0.8cm 2 and mean gradient was 2.8±1.4mmHg. Both 3D planimetry and mean gradient were very significantly correlated (r −0.5; p<0.001) (Figure 1), whereas no correlation was note between mean gradient and PHT (r 0.17; p=0.117) Conclusion: After MitraClip implantation, the assessment of mitral valve area by 3D planimetry is significantly correlated with the transmitral mean gradient, unlike PHT. Funding Acknowledgement: Type of funding sources: None.