Percutaneous Edge-to-Edge Mitral Valve Repair Escorted by Left Atrial Intracardiac Echocardiography (ICE)

Abstract

The online-only Data Supplement is available with this article at http://circ.ahajournals.org/lookup/suppl

Sequential Venous Percutaneous Transluminal Angioplasty and Balloon Dilatation of the Interatrial Septum during Percutaneous Edge-to-Edge Mitral Valve Repair

“…We performed the transseptal puncture and the whole PMVR procedure under the guidance of TEE and fluoroscopy. However, intracardiac echocardiography (ICE) can also be used for monitoring of the intervention [ 6 ].…”

Percutaneous Mitral Valve Edge-to-Edge Repair Using Volume Intracardiac Echocardiography—First in Human Experience

“…First, the volume ICE probe was advanced into the right atrium and subsequently into the left atrium (LA) as described elsewhere. 1 , 2 Three-dimensional imaging guidance was used for transseptal puncture ( Figure 1 A-D) and positioning of a superstiff wire in the left upper pulmonary vein ( Figure 1 E-F). Then, the MitraClip delivery system was advanced into the LA, the ICE catheter was switched to the LA, and the clip was positioned over the mitral valve plane ( Figure 1 G, H).…”

“…We have demonstrated before that under certain circumstances, intracardiac echocardiography (ICE) can serve as an imaging modality for PMVR. 1 , 2 A significant step to improve imaging by ICE during PMVR would be to have ICE technology with real-time 3D imaging functionality and the possibility to generate X-plane views. In this case, we used a volume ICE probe (Acuson AcuNav V, Siemens Healthcare, Mountain View, CA).…”

Peri-procedural imaging for transcatheter mitral valve replacement

“…The ICE-catheter, tipped with a miniaturized echocardiographic probe, is placed in the right atrium and notably remains stationary throughout the procedure as workstation software is manipulated to obtain different views (54). However, the experience with 2D-ICE in MitraClip implantation demonstrates that it does not allow adequate left atrial visualization to allow clip steering, leaflet visualization and grasping (55). Transventricular short and long axis ICE-views from the right ventricle have a role in evaluating left ventricular function and the presence of complications like tamponade and residual MR during the procedure.…”