Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
8667314 | Journal of the American Society of Echocardiography | 2018 | 16 Pages |
Abstract
Adaptation and evolution of transcatheter aortic valve replacement (TAVR) technologies has led to approval of TAVR for consideration in patients at intermediate risk for surgical aortic valve intervention. As TAVR becomes more mainstream, attention is shifting toward percutaneous mitral valve (MV) repair and transcatheter MV replacement (TMVR) techniques. Transcatheter heart valves (both purpose-built and off-label-use TAVR valves) are being implanted during TMVR procedures to treat clinically significant MV disease (native disease, degenerated bioprosthetic valves, and dysfunctional surgical MV annuloplasty repairs) when the risk of open heart MV surgery is prohibitive. The success of these high-risk procedures is directly related to accurate periprocedural imaging with echocardiography and other modalities. Although a multidisciplinary heart valve team approach is necessary for optimal patient selection, a multimodality team-based imaging approach and comprehensive understanding of the MV are required for safe procedural planning. Collaboration between noninvasive cardiac imagers and the intraprocedural interventional imaging team and translation of the periprocedural imaging to the implanting team are crucial to the success of TMVR technology. Currently, the TMVR procedures discussed here are conducted either as part of clinical research or off label. The US Food and Drug Administration-approved mitral valve-in-valve procedures for the treatment of degenerated mitral bioprosthetic valves are not discussed here.
Keywords
CMRAMLTMVRPMVRTHVTAVRLVOTTEETTEThree-dimensionalMDCTTransthoracic echocardiographyTransesophageal echocardiographyVirAnterior mitral leafletLeft ventricularstructural heart diseasePercutaneouspercutaneous mitral valve repairTranscatheter aortic valve replacementtranscatheter mitral valve replacementmitral stenosisMultidetector computed tomographytranscatheter heart valvemitral valvetwo-dimensionalcardiovascular magnetic resonancevalve-in-ringleft ventricular outflow tractPVLMACmitral regurgitationparavalvular leakmitral annular calcification
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Authors
G. Burkhard MD, PhD, FASE, James C. MD, Dee Dee MD, FASE, Paul J. MD, PhD, Philipp MD, Danny MD, James N. MD, FASE,