Quantification of Mitral Regurgitation by Real Time Three‐Dimensional Color Doppler Flow Echocardiography Pre– and Post–Percutaneous Mitral Valve Repair

Gruner, Christiane; Herzog, Bernhard A.; Béttex, Dominique; Felix, Carol; Datta, Saurabh; Greutmann, Matthias; Gaemperli, Oliver; Müggler, Simon Andreas; Tanner, Felix C.; Gruenenfelder, Juerg; Corti, Roberto; Biaggi, Patric

doi:10.1111/echo.12809

Cited by 20 publications

(6 citation statements)

References 28 publications

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“…It was demonstrated that measurement of flow volume through the MV by three-dimensional color Doppler echocardiography was correlated and agreed well with cardiac magnetic resonance imaging [1–3]. Gruner et al have shown that the quantification of FMR before and after percutaneous MV repair by three-dimensional FVCD was comparable to the integrative visual assessment and more reliable than the PW Doppler method [4]. Kato et al .…”

Section: Discussionmentioning

confidence: 93%

Combined flow-based imaging assessment of optimal cardiac resynchronization therapy pacing vector: a case report

et al. 2019

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Background There are still many pendent issues about the effective evaluation of cardiac resynchronization therapy impact on functional mitral regurgitation. In order to reduce the intrinsic difficulties of quantification of functional mitral regurgitation itself, an automatic quantification of real-time three-dimensional full-volume color Doppler transthoracic echocardiography was proposed as a new, rapid, and accurate method for the assessment of functional mitral regurgitation severity. Recent studies suggested that images of left ventricle flow by echo-particle imaging velocimetry could be a useful marker of synchrony. Echo-particle imaging velocimetry has shown that regional anomalies of synchrony/synergy of the left ventricle are related to the alteration, reduction, or suppression of the physiological intracavitary pressure gradients. Case summary We describe a case in which the two technologies are used in combination during acute echocardiographic optimization of left pacing vector in a 63-year-old man, Caucasian, who showed worsening heart failure symptoms a few days after an implant, and the effect of the device’s optimization at 6-month follow-up. Discussion The degree of realignment of hemodynamic forces, with quantitative analysis of the orientation of blood flow momentum ( φ ), can represent improvement of fluid dynamics synchrony of the left ventricle, and explain, with a new deterministic parameter, the effects of cardiac resynchronization therapy on functional mitral regurgitation. Real-time three-dimensional color flow Doppler quantification is feasible and accurate for measurement of mitral inflow, left ventricular outflow stroke volumes, and functional mitral regurgitation severity. Conclusion This clinical case offers an innovative and accurate approach for acute echocardiographic optimization of left pacing vector. It shows clinical utility of combined three-dimensional full-volume color Doppler transthoracic echocardiography/echo-particle imaging velocimetry assessment to increase response to cardiac resynchronization therapy, in terms of reduction of functional mitral regurgitation, improving fluid dynamics synchrony of the left ventricle. Electronic supplementary material The online version of this article (10.1186/s13256-019-2048-1) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 93%

Combined flow-based imaging assessment of optimal cardiac resynchronization therapy pacing vector: a case report

et al. 2019

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“…All patients were affected by severe MR (secondary: 5 cases or primary: 25 cases). MR severity was determined by integrating 6 criteria including qualitative (Color Doppler jet characteristics, pulmonary vein flow pattern) and quantitative (vena contracta width, regurgitant volume, regurgitant fraction, and effective regurgitant orifice area) measurements [ 15 , 16 , 17 ].…”

Section: Methodsmentioning

confidence: 99%

Head to Head Comparison between Different 3-Dimensional Echocardiographic Rendering Tools in the Imaging of Percutaneous Edge-to-Edge Mitral Valve Repair

Tamborini

Mantegazza

Garlaschè

et al. 2021

JCDD

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MitraClip (MC) is the most common percutaneous treatment for severe mitral regurgitation (MR). An accurate two-dimensional and three-dimensional echocardiographic (3DTEE) imaging is mandatory for the optimal procedural result. Recently transillumination 3DTEE rendering (3DTr) has been introduced integrating a virtual light source into the dataset and with the addition of glass effect (3DGl) allows to adjust tissue transparency improving depth perception and anatomical structure delineation in comparison with the standard 3DTEE (3DSt). The aim of this retrospective study in 30 patients undergoing MC, was to compare 3DSt, 3DTr, and 3DGl in mitral valve (MV) evaluation and procedural result assessment. 3DTEE acquisitions obtained before and after MC were processed with 3DSt, 3DTr, and 3DGl rendering. Each reconstruction was scored for quality and for ability to recognize MV anatomy, MR origin, clip position, dimension and grasping. Imaging quality was judged good or optimal in 52%, 76%, and 96% in 3DSt, 3DTr, and 3DGl reconstructions respectively. In 26/30 patients a diagnostic incremental value was found with 3DTr vs. 3DSt and in 15/26 with 3DGl vs. 3DTr and 3DSt. Only 3DGl with perpendicular cropping of the clip allowed to visualize and measure the grasped portion of each mitral leaflets. 3DTEE imaging during MC may be improved by 3DTr and 3DGl providing a better evaluation of MV, of leaflet grasping and of residual MR jets after MC.

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“…Mitral and pulmonary vein inflow patterns, change in forward stroke volume, and continuous wave jet profile. The primary quantitative parameter still valid following an edge-to-edge repair is three-dimensional color Doppler direct planimetry of the vena contracta areas (19, 29, 30). 3D color Doppler multiplanar reconstruction may be the method of choice to evaluate residual vena contracta area.…”

Section: Mitraclipmentioning

confidence: 99%

Percutaneous Mitral Valve Repair: Multi-Modality Cardiac Imaging for Patient Selection and Intra-Procedural Guidance

Khalique

Hahn

2019

Front. Cardiovasc. Med.

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Percutaneous mitral valve repair is an important procedure for patients at high risk of surgical mitral valve repair. Multi-modality Cardiac Imaging plays a key role in these procedures. MitraClip is the first and most utilized percutaneous mitral repair device and experience is has grown to treat not only typical but atypical and complex lesions. Cardioband is an emerging percutaneous annuloplasty system with promising early results. This review will focus on the comprehensive multi-modality cardiac imaging for patient selection and intra-procedural guidance of the MitraClip and Cardioband systems.

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Quantification of Mitral Regurgitation by Real Time Three‐Dimensional Color Doppler Flow Echocardiography Pre– and Post–Percutaneous Mitral Valve Repair

Cited by 20 publications

References 28 publications

Combined flow-based imaging assessment of optimal cardiac resynchronization therapy pacing vector: a case report

Combined flow-based imaging assessment of optimal cardiac resynchronization therapy pacing vector: a case report

Head to Head Comparison between Different 3-Dimensional Echocardiographic Rendering Tools in the Imaging of Percutaneous Edge-to-Edge Mitral Valve Repair

Percutaneous Mitral Valve Repair: Multi-Modality Cardiac Imaging for Patient Selection and Intra-Procedural Guidance

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