Universität zu Köln

Altiok, Ertunc, Hamada, Sandra, Brehmer, Kathrin, Kuhr, Kathrin, Reith, Sebastian, Becker, Michael, Schroeder, Joerg, Almalla, Mohammad, Lehmacher, Walter, Marx, Nikolaus and Hoffmann, Rainer (2012). Analysis of Procedural Effects of Percutaneous Edge-to-Edge Mitral Valve Repair by 2D and 3D Echocardiography. Circ.-Cardiovasc. Imaging, 5 (6). S. 748 - 756. PHILADELPHIA: LIPPINCOTT WILLIAMS & WILKINS. ISSN 1941-9651

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Abstract

Background-Analysis of procedural effects in patients undergoing percutaneous mitral valve repair (PMVR) using the edge-to-edge technique is complex, and common methods to define mitral regurgitation severity based on 2-dimensional (2D) echocardiography are not validated for postprocedural double-orifice mitral valve. This study used 3D transesophageal echocardiography (TEE) to determine the functional and morphological effects of PMVR. Methods and Results-In 39 high-risk surgical patients with moderate to severe functional mitral valve regurgitation, 3D TEE with and without color Doppler as well as 2D transthoracic and TEE was performed before and after PMVR (MitraClip device). Mitral valve regurgitant volume by color Doppler 3D TEE was determined as the product of vena contracta areas defined by direct planimetry and velocity time integral using continuous-wave Doppler. Regurgitant volume was reduced from 84.1 +/- 38.3 mL preintervention to 35.6 +/- 25.6 mL postintervention. Patients in whom vena contracta area could be reduced >50% had a smaller preprocedural mitral annulus area compared with patients with <= 50% reduction (11.9 +/- 3.9 versus 16.1 +/- 8.5 cm(2), respectively; P=0.036) and tended to have a smaller mitral annulus circumference (13.0 +/- 2.0 versus 14.8 +/- 4.1 cm, respectively; P=0.112). At 6 months follow-up, left atrial and left ventricular end-diastolic volumes were significantly more reduced in patients in whom regurgitant vena contracta area was reduced by >50% compared with those with less reduction (-11.4 +/- 5.2 versus -4.8 +/- 7.7%; P=0.005, and -11.0 +/- 7.2 versus -4.5 +/- 9.3%; P=0.028). The maximum diastolic mitral valve area decreased from 6.0 +/- 2.0 to 2.9 +/- 0.9 cm(2) (P<0.0001). Conclusions-Three dimensional TEE demonstrates significant reduction of regurgitant volume after PMVR. The unique visualization of the mitral valve by 3D TEE allows improved understanding of the morphological and functional changes induced by PMVR. (Circ Cardiovasc Imaging. 2012;5:748-755.)

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Altiok, Ertunc UNSPECIFIED UNSPECIFIED UNSPECIFIED Hamada, Sandra UNSPECIFIED UNSPECIFIED UNSPECIFIED Brehmer, Kathrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuhr, Kathrin UNSPECIFIED UNSPECIFIED UNSPECIFIED Reith, Sebastian UNSPECIFIED UNSPECIFIED UNSPECIFIED Becker, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Schroeder, Joerg UNSPECIFIED UNSPECIFIED UNSPECIFIED Almalla, Mohammad UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehmacher, Walter UNSPECIFIED UNSPECIFIED UNSPECIFIED Marx, Nikolaus UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoffmann, Rainer UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-480393
DOI:	10.1161/CIRCIMAGING.112.974691
Journal or Publication Title:	Circ.-Cardiovasc. Imaging
Volume:	5
Number:	6
Page Range:	S. 748 - 756
Date:	2012
Publisher:	LIPPINCOTT WILLIAMS & WILKINS
Place of Publication:	PHILADELPHIA
ISSN:	1941-9651
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TIME 3-DIMENSIONAL ECHOCARDIOGRAPHY; VENA CONTRACTA AREA; COLOR DOPPLER-ECHOCARDIOGRAPHY; TRANSESOPHAGEAL ECHOCARDIOGRAPHY; QUANTITATIVE ASSESSMENT; CLINICAL-TRIAL; IN-VITRO; REGURGITATION; SEVERITY; DISEASE Multiple languages Cardiac & Cardiovascular Systems; Radiology, Nuclear Medicine & Medical Imaging Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/48039