Utility of Real-Time Three-Dimensional Transesophageal Echocardiography in Evaluating the Success of Percutaneous Transcatheter Closure of Mitral Paravalvular Leaks

Ma, García-Fernández; Cortés, Marcelino; García-Robles, José Antonio; Diego, José Juan Gómez de; Pérez-David, Esther; Garcı́a, Eulogio

doi:10.1016/j.echo.2009.09.028

Cited by 83 publications

(49 citation statements)

References 18 publications

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“…Three-dimensional TEE is superior to 2-dimentional TEE for the evaluation of paravalvular regurgitation because it provides improved localization and analysis of the PVL size and shape. 25,26 We suggest a future study to compare the diagnostic value of cardiac CT with 3-dimensional TEE for PVL evaluation, including its detection, localization, and measurement of size.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Mitral Paravalvular Leakage After Mitral Valve Replacement Using Cardiac Computed Tomography

Suh

Hong

Han

et al. 2016

Circ: Cardiovascular Imaging

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P aravalvular leakage (PVL) is uncommon but potentially serious complication after valve replacement, which occurs 7% to 17% after mitral valve replacement (MVR) and 2% to 10% after aortic valve replacement.1,2 Although most PVLs are asymptomatic and have a benign clinical course, an estimated 1% to 5% of patients with PVLs show serious clinical consequences, with especially more undesirable outcomes being observed in mitral PVL with higher reoperation rates. 3-5 See Editorial by Khalique and Hahn See Clinical PerspectiveCurrently, transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) are commonly used to evaluate the prosthetic valve along with the presence of PVL. TTE is the first-line imaging method for PVL detection, and TEE can be of additional diagnostic value especially for valves in the mitral position.6,7 However, echocardiography has limitations in prosthetic valve evaluation because of imaging distortions from acoustic shadowing, and TEE is semiinvasive, another limitation.Cardiac computed tomography (CT) is an emerging technique which has received attention for its role in the evaluation of prosthetic valves. A few studies have reported on the use of cardiac CT in the diagnosis of prosthetic valve dysfunction. 8-11Although cardiac CT is thought to have diagnostic value in the detection or localization of PVL 12-14 and thought to help the successful percutaneous closure of mitral PVL, 15 the diagnostic performance of cardiac CT for detection of mitral PVL has not been investigated in a large population.The purposes of our study was to investigate the diagnostic accuracy of cardiac CT for the detection of PVL in prosthetic mitral valves (MVs), using surgical findings as the standard Background-The diagnostic performance of cardiac computed tomography (CT) for detection of paravalvular leakage (PVL) after mitral valve replacement has not been investigated in a large population. We aimed to investigate the diagnostic accuracy of CT for diagnosis of mitral PVL using surgical findings as the standard reference and to compare the diagnostic performance of CT with those of transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). Methods and Results-A total of 204 patients with previous mitral valve replacement who underwent cardiac CT were retrospectively included. The presence of mitral PVL was analyzed on CT, TTE, and TEE. In 78 patients who underwent redo-surgery, diagnostic performance for the detection of PVL for CT, TTE, and TEE were compared with surgical findings as the standard reference.

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Section: Discussionmentioning

confidence: 99%

Assessment of Mitral Paravalvular Leakage After Mitral Valve Replacement Using Cardiac Computed Tomography

Suh

Hong

Han

et al. 2016

Circ: Cardiovascular Imaging

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“…RT-3DTEE can address the shortcomings of 2DTEE and demonstrate the exact number, sites, size, and shape of the PVLs. 23, 25 We had considerable difficulty in detecting more than 1 PVL with 2DTEE. However, with the help of RT-3DTEE it was relatively easy to detect all PVLs.…”

Section: Discussionmentioning

confidence: 99%

“…18,[21][22][23][24][25] This can be important in deciding whether the patient will undergo a surgical or transcatheter approach for the correction of the paravalvular regurgitation.…”

Section: Discussionmentioning

confidence: 99%

Utility of Real-Time 3-Dimensional Transesophageal Echocardiography in the Assessment of Mitral Paravalvular Leak

Arribas-Jiménez

Rama-Merchán

Barreiro-Pérez

et al. 2016

Circ J

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“…Color Doppler can help identify the location, direction, and severity of regurgitant blood flow. However, because the spatial resolution of traditional TEE and TTE is limited, the addition of 3D allows for improved spatial resolution and therefore provides more information regarding the size and shape of PVLs [24,25]. This information is especially helpful during percutaneous closure procedures.…”

Section: Incidencementioning

confidence: 99%

“…At this time, the majority of percutaneous PVR repairs are performed with Amplatzer devices (St. Jude Medical, St. Paul, Minnesota, USA), although vascular coils have also been used [1,20,25,[41][42][43]. The devices used are either cylindrical or oval in shape.…”

Section: Treatmentmentioning

confidence: 99%

Real-Time 3D Transesophageal Echocardiographic Guidance of Prosthetic Valve Paravalvular Leak

Venturini¹,

Mediratta²,

Addetia³

et al. 2015

jshd

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Key Word 3D TEE Guidance Cases Case 1A 64-year-old female with history of congenital heart disease requiring ostium primum atrial septal defect (ASD) repair and multiple mitral valve replacements presented with worsening heart failure. Most recently, she underwent a third mechanical mitral valve replacement (in the setting of severe PVL), mechanical aortic valve replacement, tricuspid valve repair, and ventricular septal defect repair. Since her last surgery, she developed New York Heart

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Utility of Real-Time Three-Dimensional Transesophageal Echocardiography in Evaluating the Success of Percutaneous Transcatheter Closure of Mitral Paravalvular Leaks

Cited by 83 publications

References 18 publications

Assessment of Mitral Paravalvular Leakage After Mitral Valve Replacement Using Cardiac Computed Tomography

Assessment of Mitral Paravalvular Leakage After Mitral Valve Replacement Using Cardiac Computed Tomography

Utility of Real-Time 3-Dimensional Transesophageal Echocardiography in the Assessment of Mitral Paravalvular Leak

Real-Time 3D Transesophageal Echocardiographic Guidance of Prosthetic Valve Paravalvular Leak

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