Development of Mitral Stenosis After Mitral Valve Repair: Importance of Mitral Valve Area

2017 ◽  
Vol 33 (12) ◽  
pp. 1701-1707 ◽  
Author(s):  
Kwan Leung Chan ◽  
Shin-Yee Chen ◽  
Thierry Mesana ◽  
Buu Khanh Lam
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Mitral Stenosis ◽  
Valve Repair ◽  
Mitral Valve Area ◽  
Valve Area

scholarly journals P1798 Determinants of increased mitral mean diastolic gradient after transcatheter edge-to-edge mitral valve repair

2020 ◽  
Vol 21 (Supplement_1) ◽  
Author(s):  
D Oguz ◽  
R Padang ◽  
S V Pislaru ◽  
V T Nkomo ◽  
S V Mankad ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Regurgitation ◽  
Mitral Valve Repair ◽  
Mitral Stenosis ◽  
Valve Repair ◽  
Mitral Valve Area ◽  
Post Procedure ◽  
Significant Difference ◽  
2D And 3D ◽  
Valve Area

Abstract Background Transcatheter edge-to-edge mitral valve repair (TMVR; MitraClip, Abbott Vascular) is clinically approved for treatment of severe, symptomatic mitral regurgitation (MR) in high or prohibitive surgical risk patients. Iatrogenic mitral stenosis is a known complication of TMVR, but determinants of increased post-procedure mean diastolic gradient are not well defined. Purpose We aimed to investigate the determinants of increased mitral mean diastolic gradient after TMVR. Methods We retrospectively reviewed 59 patients. 2D and 3D TEE data sets acquired before and immediately after procedure were analyzed. 4D Cardio-View and 4D MV-Assessment (TomTec, Germany) were used for the analysis of the 3D volume data set. Quantitative mitral valve analysis was done at the end of systole. Increased mitral mean diastolic gradient after TMVR was correlated with pre-procedure 2D and 3D echocardiographic data. Results 34 patients had primary MR, 25 patients had mixed/secondary MR. Baseline mean mitral diastolic gradient was 2.0 ± 0.9mmHg and increased to 3.9 ± 1.8mmHg post-TMVR and the mean 3D planimetric mitral valve area decreased from 5.3 ± 1.5cm2 to 2.6 ± 1.0cm2. Implantation of multiple clips was performed less frequently in patients with smaller baseline mitral valve area; 8% vs 47% in the lowest quartile vs all others (p = 0.006). 12(20%) of patients had a mean diastolic gradient >5mmHg post-TMVR and 15(25%) of patients had a post-TMVR mitral valve area <2.0 cm2. There was no significant difference in post-procedure heart rate between patients with mean diastolic gradient ≤5mmHg vs >5mmHg (p = 0.08). Patient characteristics according to post-TMVR mean diastolic gradient are shown in the Table. Post-TMVR mean diastolic gradient >5mmHg was more common in patients with increased pre-procedure mean diastolic gradient(p = 0.006), post-TMVR mitral valve area <2.0 cm2(40% vs 14%, p = 0.03), and ≥moderate residual mitral regurgitation(38% vs 11%, p = 0.02). Post-TMVR mitral valve area <2.0cm2 was present in 50% vs 19% of patients with vs without a mean gradient >5mmHg(p = 0.04). Conclusions Elevated post-TMVR mean diastolic gradient is multifactorial and related to mitral stenosis, but residual mitral regurgitation also appears to be an important contributor to increased gradients in some patients. Larger cohorts are likely needed to assess the concurrent impact of mitral annular calcification, leaflet calcification, and other variables on post-TMVR mean gradient. Abstract P1798 Figure. 2D and 3D Echocardiographic Parameters

Intraoperative Assessment of Mitral Valve Area After Mitral Valve Repair: Comparison of Different Methods

2011 ◽  
Vol 25 (2) ◽  
pp. 221-228 ◽  
Author(s):  
Andrew Maslow ◽  
Anthony Gemignani ◽  
Arun Singh ◽  
Feroze Mahmood ◽  
Athena Poppas
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Valve Repair ◽  
Mitral Valve Area ◽  
Intraoperative Assessment ◽  
Valve Area

P-53 Intraoperative determination of mitral valve area after mitral valve repair surgery: 3-D planimetry vs. pressure-half time

2011 ◽  
Vol 25 (3) ◽  
pp. S56 ◽  
Author(s):  
Woon-Seok Kang ◽  
Ji-Eun Song ◽  
Hasmizy Muhammad ◽  
Seong-Hyop Kim ◽  
Tae-G. yoon Yoon ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Half Time ◽  
Valve Repair ◽  
Mitral Valve Area ◽  
P 53 ◽  
Valve Area

scholarly journals Mitral valve area by the pressure half-time method does not correlate with mean gradient in mitral valve repair patients

2010 ◽  
Vol 12 (2) ◽  
pp. 124-130 ◽  
Author(s):  
C. M. House ◽  
W. B. Nelson ◽  
G. A. Nickele ◽  
I. Ahmed ◽  
R. Dahiya
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Half Time ◽  
Valve Repair ◽  
Mitral Valve Area ◽  
Valve Area

scholarly journals Assessment of Mitral Valve Area During Percutaneous Mitral Valve Repair Using the MitraClip System

2013 ◽  
Vol 6 (6) ◽  
pp. 1032-1040 ◽  
Author(s):  
Patric Biaggi ◽  
Christian Felix ◽  
Christiane Gruner ◽  
Bernhard A. Herzog ◽  
Sabine Hohlfeld ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Mitral Valve Repair ◽  
Valve Repair ◽  
Mitral Valve Area ◽  
Percutaneous Mitral Valve Repair ◽  
Mitraclip System ◽  
Valve Area
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