Interventional Echocardiography of the MV: What the Interventionalist Wants to Know

Semin Cardiothorac Vasc Anesth. 2019 Mar;23(1):37-47. doi: 10.1177/1089253218778822. Epub 2018 Jun 13.

Abstract

The past 2 decades have seen a proliferation of transcatheter mitral valve (MV) therapies, which are less invasive and distinct from surgical MV repair or replacement. The commonly used MV transcatheter therapies include (1) percutaneous mitral balloon commissurotomy (PMBC) for rheumatic mitral stenosis; (2) edge-to-edge repair with the MitraClip for mitral regurgitation; (3) valve-in-valve implantation in bioprosthetic MV, native MV, or mitral ring; and (4) closure of paravalvular leaks (PVLs). This article will focus on the use of echocardiography in the diagnosis, patient selection, procedural guidance, and postprocedural follow-up for PMBC, with notes on the role of transesophageal echocardiography in transcatheter interventions for prosthetic valve degeneration and PVL closure.

Keywords: mitral paravalvular leak; percutaneous mitral balloon commissurotomy; procedural TEE; rheumatic mitral stenosis; transcatheter valve therapy.

Publication types

  • Review

MeSH terms

  • Angioplasty, Balloon / methods*
  • Echocardiography / methods*
  • Echocardiography, Transesophageal
  • Heart Valve Prosthesis Implantation / methods*
  • Humans
  • Mitral Valve / diagnostic imaging
  • Mitral Valve / surgery
  • Mitral Valve Insufficiency / diagnostic imaging
  • Mitral Valve Insufficiency / therapy*
  • Mitral Valve Stenosis / diagnostic imaging
  • Mitral Valve Stenosis / therapy*
  • Patient Selection
  • Ultrasonography, Interventional / methods*