Background-Transcatheter mitral valve repair (TMVR) is a treatment option in patients with symptomatic functional or degenerative mitral regurgitation (DMR) at high surgical risk. The acute effect of MitraClip procedure on mitral valve (MV) annular geometry and its relation to functional outcomes is unclear. We sought to assess immediate effect of TMVR on MV annular geometry with 3-dimensional (3D) transesophageal echocardiography and the association of MV diameter reduction with functional response after 6 months. , and MV annular geometry (MV sphericity index, 0.9±0.1 and 0.8±0.1; P<0.0001); the lateral medial MV diameters remained unchanged (4.3±0.7 and 4.4±0.6 cm; P=0.13). In subjects with DMR, all MV annular geometry-defining values were not significantly altered after TMVR (n=36; P>0.05). Acute anterior-posterior diameter reduction was associated with clinical response to TMVR after 6 months of follow-up (cutoff value, ≥6.4%; area under the curve, 0.81; P=0.002; sensitivity, 81.6%; specificity, 81.8%), which was confirmed by additional regression analysis (P=0.007). Conclusions-Three-dimensional transesophageal echocardiography enables assessment of acute changes of MV geometry in patients undergoing the MitraClip procedure. Only patients with functional mitral regurgitation experienced significant reduction of MV annular dimensions, which was associated with clinical response to TMVR. (Circ Cardiovasc Interv. 2014;7:390-399.)
Methods and Results-Consecutive