Imaging for Best Outcomes in Structural Heart Interventions Special Issue
Imaging Guidance for Transcatheter Mitral Valve Intervention on Prosthetic Valves, Rings, and Annular Calcification

https://doi.org/10.1016/j.jcmg.2019.10.027Get rights and content
Under an Elsevier user license
open archive

Highlights

  • Computed tomography is an essential imaging modality for patient selection and procedural planning of catheter-based mitral valve interventions on a prosthetic valve or calcified native annulus.

  • Echocardiography and limited fluoroscopy are principal imaging tools for intraprocedural guidance. Echocardiography is well suited for acute postprocedure functional evaluation.

  • Accurate prediction of left ventricular outflow tract patency is a specific imaging challenge for these interventions.

  • Functional evaluation of residual mitral regurgitation and paravalvular regurgitation post procedure are important tasks for the echocardiographer.

Abstract

Catheter-based interventions to improve mitral valve function are dependent on anatomic and functional information provided by noninvasive imaging to plan, perform, and evaluate each intervention. In this review we highlight the importance of imaging guidance for catheter-based interventions on prosthetic mitral valves, surgical rings, and native valve annular calcification. Both repair and replacement procedures are discussed. We review the general features common to this collection of procedures and discuss specific imaging issues and concerns for each procedure. Figures and intraprocedural videos emphasize central messages using case examples.

Key Words

mitral valve
paravalvular repair
transcatheter
valve-in-mitral annular calcification
valve-in-ring
valve-in-valve

Abbreviations and Acronyms

3D
3 dimensional
CT
computed tomography
LA
left atrium
LV
left ventricle
LVOT
left ventricular outflow tract
MAC
mitral annular calcification
MR
mitral regurgitation
MViR
mitral valve-in-ring
MViV
mitral valve-in-valve
PVR
paravalvular regurgitation
TEE
transesophageal echocardiography
THV
transcatheter heart valve
SHV
surgical heart valve
ViMAC
valve-in-mitral annular calcification

Cited by (0)

The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors’ institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the Author Center.