Multimodality Imaging in Transcatheter Mitral Interventions

Khalique, Omar; Hahn, Rebecca T.

doi:10.1161/circimaging.116.005071

Cited by 7 publications

(6 citation statements)

References 35 publications

(32 reference statements)

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“…Echocardiography is the cornerstone of intraprocedural guidance as it provides real-time images, thus allowing dynamic step-by-step guidance in all the procedures and real-time instantaneous decision-making. [6][7][8][9][10][11] High-resolution, real-time echocardiographic imaging using two-dimensional and three-dimensional modalities and rapid postprocessing imaging inside the operating room are fundamental tools for the treatment of structural heart disease. Three-dimensional echocardiography has been shown to overcome the limits of two-dimensional images in displaying structures and fine details of anatomy.…”

Section: Discussionmentioning

confidence: 99%

“…The present study represents the first data collection exploring the perceived added value of transillumination rendering compared with the conventional rendering methods in the setting of interventional imaging. Echocardiography is the cornerstone of intraprocedural guidance as it provides real-time images, thus allowing dynamic step-by-step guidance in all the procedures and real-time instantaneous decision-making 6–11 …”

Section: Discussionmentioning

confidence: 99%

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TrueVue transillumination volume rendering for three-dimensional transoesophageal echocardiography in interventional imaging

Gavazzoni

Tagliari

Taramasso

et al. 2021

Journal of Cardiovascular Medicine

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Aims The aim of the present article is to address the advantages of real-time TrueVue transillumination rendering for three-dimensional transoesophageal echocardiography in the context of echocardiographic procedural guidance for structural interventions for several procedural concerns.Methods Procedures in which transillumination imaging was used during at least one step of the whole intervention were retrospectively collected; the loops were reviewed by an experienced imaging specialist and the most important concerns imaged in the loops were listed. The apparent added value of transillumination for each of these concerns was scored independently by two imager specialists, and their agreement was derived.Results Between January and June 2019, 50 procedures were performed in our centre. Transillumination imaging was used in 64% of these cases. Considering all the loops the added value of transillumination compared with the conventional rendering was scored greater than 3 in a Likert scale in 87% of analysed loops by both the operators with a good agreement (k U 0.47, P U 0.001). A different level of perceived advantage and agreement was observed between three image features that improved: substantial agreement (k U 0.652, P U 0.001) for enhancing the contrast between structures and cavities (n U 24 loops); good agreement for the contrast between different structures (k U 0.588, P U 0.002) (n U 37 loops); moderate agreement for the perception of interaction between the device and structures (k U 0.3, P U 0.027) (n U 7 loops). ConclusionThe use of new volume-rendering techniques in interventional imaging may be useful especially for solving the concerns regarding the cavity-structure contrast.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

TrueVue transillumination volume rendering for three-dimensional transoesophageal echocardiography in interventional imaging

Gavazzoni

Tagliari

Taramasso

et al. 2021

Journal of Cardiovascular Medicine

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Section: Discussionmentioning

confidence: 99%

“…Acute procedural success rates of valve-in-ring procedures are estimated to be around 70%,[ 1 ] primarily limited by paravalvular leaks, device dislocation, and left ventricular outflow tract obstruction. [ 1 ] In the case presented, we report a MV-in-valve-in-ring procedure as a feasible bailout strategy to overcome valve-in-ring complications such as device malapposition resulting in persistent MR after the procedure. In the most recent transcatheter MVR registry, intra-prosthetic anterograde mean gradient reported at follow-up was 6.7 + 3.1 mmHg[ 2 ] and is comparable with the final result of this case (8 mmHg) despite the two valves implanted.…”

Section: Discussionmentioning

confidence: 99%

Valve-in-valve-in-ring: A bailout strategy to tackle paravalvular leaks due to device malapposition

Vairo

Conrotto

Franchin

et al. 2021

J Cardiovasc Echography

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A 55-year-old male with a history of severe organic mitral regurgitation treated with surgical mitral valve (MV) repair was referred for a transcatheter MV replacement due to recurrent regurgitation. After the release of the first transcatheter MV, a severe paravalvular leak coming from the lateral side was observed. To promptly tackle this issue, a second valve with further postdilation was successfully implanted and the paravalvular leak disappeared. This case highlights the feasibility of implanting a second valve in case of severe paravalvular leaks after MV-in-ring procedures due to device malapposition.

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“…MDCT, thanks to its excellent bloodtissue interface and the high-spatial 3D imaging, provides a comprehensive visualization of cardiac and vascular structures and can give detailed information on mitral annular shape and sizing, valvular calcification, papillary muscles position and dimension, LV shape and dimension, and the relationship of the heart with chest wall. Furthermore, multiplanar and curved planar (CPR) reconstructions allow a comprehensive assessment of the course of coronary arteries and veins with respect to MV apparatus [33] .…”

Section: Computed Tomographymentioning

confidence: 99%

Multimodality imaging for preprocedural planning of percutaneous mitral valve repair: a comprehensive review

Melillo¹,

Boccellino²,

Ingallina³

et al. 2020

Mini-invasive Surg

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New transcatheter mitral valve (MV) therapies are now available as alternatives to surgical and medical treatments in patients at high or prohibitive operative risk. Multimodality imaging including echocardiography, cardiac magnetic resonance, and cardiac computed tomography provide complementary information to guide patient and device selection. Morphology and functional anatomy of the MV should be carefully evaluated to determine the feasibility of percutaneous treatment; to identify the best therapeutic approach, either leaflet or annulus or combined; and to predict the probability of procedural success that is crucial for subsequent outcome and should be integrated by comprehensive preprocedural assessment of chamber size, biventricular systolic and diastolic function, valvopathy hemodynamic impact and aortic or peripheral vascular disease. The spectrum of transcatheter options is now wide and encompasses leaflet repair, direct or indirect annuloplasty, and cordal implantation. The aim of this review is to provide an overview on the role of multimodality imaging in the patient selection and preprocedural planning of percutaneous mitral valve repair.

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Multimodality Imaging in Transcatheter Mitral Interventions

Cited by 7 publications

References 35 publications

TrueVue transillumination volume rendering for three-dimensional transoesophageal echocardiography in interventional imaging

TrueVue transillumination volume rendering for three-dimensional transoesophageal echocardiography in interventional imaging

Valve-in-valve-in-ring: A bailout strategy to tackle paravalvular leaks due to device malapposition

Multimodality imaging for preprocedural planning of percutaneous mitral valve repair: a comprehensive review

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