Transesophageal Echocardiographic Planning and Neo–Left Ventricular Outflow Tract Assessment for Transcatheter Mitral Valve Implantation Using Novel Software

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Highlights

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New echo software aids periprocedural screening before transcather MV implantation.
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Virtual valve can be directly projected in the 3D datasets.
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It may be useful for patients unable to undergo contrast-enhanced CCT scans.

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Most cited references 4

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Clinical Trial Design Principles and Endpoint Definitions for Transcatheter Mitral Valve Repair and Replacement: Part 2: Endpoint Definitions: A Consensus Document From the Mitral Valve Academic Research Consortium.

Gregg Stone, David Adams, William T. Abraham … (2015)

Mitral regurgitation (MR) is one of the most prevalent valve disorders and has numerous etiologies, including primary (organic) MR, due to underlying degenerative/structural mitral valve (MV) pathology, and secondary (functional) MR, which is principally caused by global or regional left ventricular remodeling and/or severe left atrial dilation. Diagnosis and optimal management of MR requires integration of valve disease and heart failure specialists, MV cardiac surgeons, interventional cardiologists with expertise in structural heart disease, and imaging experts. The introduction of transcatheter MV therapies has highlighted the need for a consensus approach to pragmatic clinical trial design and uniform endpoint definitions to evaluate outcomes in patients with MR. The Mitral Valve Academic Research Consortium is a collaboration between leading academic research organizations and physician-scientists specializing in MV disease from the United States and Europe. Three in-person meetings were held in Virginia and New York during which 44 heart failure, valve, and imaging experts, MV surgeons and interventional cardiologists, clinical trial specialists and statisticians, and representatives from the U.S. Food and Drug Administration considered all aspects of MV pathophysiology, prognosis, and therapies, culminating in a 2-part document describing consensus recommendations for clinical trial design (Part 1) and endpoint definitions (Part 2) to guide evaluation of transcatheter and surgical therapies for MR. The adoption of these recommendations will afford robustness and consistency in the comparative effectiveness evaluation of new devices and approaches to treat MR. These principles may be useful for regulatory assessment of new transcatheter MV devices, as well as for monitoring local and regional outcomes to guide quality improvement initiatives.

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Neo-LVOT and Transcatheter Mitral Valve Replacement

Anna Reid, Sagit Ben Zekry, Mansi Turaga … (2021)

With the advent of transcatheter mitral valve replacement (TMVR), the concept of the neo-left ventricular outflow tract (LVOT) was introduced and remains an essential component of treatment planning. This paper describes the LVOT anatomy and provides a step-by-step computed tomography methodology to segment and measure the neo-LVOT while discussing the current evidence and outstanding challenges. It also discusses the technical and hemodynamic factors that play a major role in assessing the neo-LVOT. A summary of expert-based recommendations about the overall risk of LVOT obstruction in different scenarios is presented along with the currently available methods to reduce the risk of LVOT obstruction and other post-procedural complications.

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Current Indications for Transcatheter Mitral Valve Replacement Using Transcatheter Aortic Valves : Valve-in-Valve, Valve-in-Ring, and Valve-in-Mitral Annulus Calcification

Marina Urena, Alec Vahanian, Eric Brochet … (2021)

Use of transcatheter mitral valve replacement (TMVR) using transcatheter aortic valves in clinical practice is limited to patients with failing bioprostheses and rings or mitral valve disease associated with severe mitral annulus calcification. Whereas the use of valve-in-valve TMVR appears to be a reasonable alternative to surgery in patients at high surgical risk, much less evidence supports valve-in-ring and valve-in-mitral annulus calcification interventions. Data on the results of TMVR in these settings are derived from small case series or voluntary registries. This review summarizes the current evidence on TMVR using transcatheter aortic valves in clinical practice from the characteristics of the TMVR candidates, screening process, performance of the procedure, and description of current results and future perspectives. TMVR using dedicated devices in native noncalcified mitral valve diseases is beyond the scope of the article.

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Author and article information

Contributors

Joanna Bartkowiak

Journal

Journal ID (nlm-ta): CASE (Phila)

Journal ID (iso-abbrev): CASE (Phila)

Title: CASE : Cardiovascular Imaging Case Reports

Publisher: Elsevier

ISSN (Electronic): 2468-6441

Publication date PMC-release: 06 March 2024

Publication date Collection: April 2024

Publication date (Electronic): 06 March 2024

Volume: 8

Issue: 4

Pages: 292-295

Affiliations

[a ]Department of Medicine, NewYork-Presbyterian/Columbia University Irving Medical Center, New York, New York

[b ]Division of Cardiac, Thoracic and Vascular Surgery, Department of Surgery, New York-Presbyterian Hospital, Columbia University Medical Center, New York, New York

Author notes

[∗ ]Correspondence: Dr Joanna Bartkowiak, MD, Columbia University Irving Medical Center, New York-Presbyterian Hospital, 177 Fort Washington Avenue, New York, NY 10032. jb4858@ 123456cumc.columbia.edu

Article

Publisher Item ID: S2468-6441(24)00058-6

DOI: 10.1016/j.case.2024.02.002

PMC ID: 11096663

SO-VID: f320be7f-0816-4307-a8f0-6bca0add90b4

License:

This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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Transesophageal Echocardiographic Planning and Neo–Left Ventricular Outflow Tract Assessment for Transcatheter Mitral Valve Implantation Using Novel Software

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Most cited references 4

Clinical Trial Design Principles and Endpoint Definitions for Transcatheter Mitral Valve Repair and Replacement: Part 2: Endpoint Definitions: A Consensus Document From the Mitral Valve Academic Research Consortium.

Neo-LVOT and Transcatheter Mitral Valve Replacement

Current Indications for Transcatheter Mitral Valve Replacement Using Transcatheter Aortic Valves : Valve-in-Valve, Valve-in-Ring, and Valve-in-Mitral Annulus Calcification

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