Clinical InvestigationEchocardiography and Percutaneous Mitral Valve InterventionsSystematic Fluoroscopic-Echocardiographic Fusion Imaging Protocol for Transcatheter Edge-to-Edge Mitral Valve Repair Intraprocedural Monitoring
Section snippets
Study Design and End Points
We included all consecutive patients who underwent TMVr with the MitraClip (Abbot Vascular, Santa Clara, CA) and the EchoNavigator system (Philips Medical Systems, Best, the Netherlands) in whom FI was used for procedural guidance (FI+), from October 2016 to July 2018 (22 months). We compared them with the last consecutive patients who underwent the procedure immediately before the introduction of FI in our department (FI−), from January 2015 to September 2016 (21 months).
The primary end point
Study Population
The study included 160 consecutive patients (mean age, 75 ± 9 years; 64.4% men): the first 80 patients (50%) were treated with conventional intraprocedural monitoring (FI−), and the last 80 (50%) were treated using FI for procedural guidance (FI+). All patients in the FI− group were treated with the MitraClip NT device, while the MitraClip XT device was used in 15 patients of the FI+ group and the MitraClip NT in the remaining 65.
Baseline clinical characteristics and echocardiographic data were
Discussion
This is among the first studies of patients treated with TMVr using FI for intraprocedural monitoring.
We showed that the use of FI (1) reduces fluoroscopy time and (2) increases procedural success in a population with a high prevalence of challenging anatomies for percutaneous repair.
Most baseline clinical and echocardiographic characteristics were very similar between the two consecutive groups, allowing direct comparison between FI− and FI+ patients.
The impact of the newer MitraClip XT device
Conclusion
In our study, the use of FI during TMVr was feasible and safe. The application of our standardized protocol was independently associated with a reduction in fluoroscopy time and improved procedural success in a population with a high prevalence of challenging anatomies for percutaneous mitral repair.
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Conflicts of Interest: None.