Guidance of the MitraClip® procedure by 2D and 3D imaging

Louis Labrousse; Marina Dijos; Lionel Leroux; Pierre Oses; Benjamin Seguy; Muriel Markof; Stéphane Lafitte

doi:10.1016/j.acvd.2018.05.003

Guidance of the MitraClip^® procedure by 2D and 3D imaging

Arch Cardiovasc Dis. 2018 Jun-Jul;111(6-7):432-440. doi: 10.1016/j.acvd.2018.05.003. Epub 2018 Jul 7.

Authors

Louis Labrousse¹, Marina Dijos², Lionel Leroux², Pierre Oses², Benjamin Seguy², Muriel Markof², Stéphane Lafitte²

Affiliations

¹ Medico-Surgical Department (Valvulopathies, Cardiac Surgery, Adult Interventional Cardiology), hôpital cardiologique de Haut-Lévèque, Bordeaux University Hospital, 33604 Pessac, France. Electronic address: [email protected].
² Medico-Surgical Department (Valvulopathies, Cardiac Surgery, Adult Interventional Cardiology), hôpital cardiologique de Haut-Lévèque, Bordeaux University Hospital, 33604 Pessac, France.

PMID: 30041732
DOI: 10.1016/j.acvd.2018.05.003

Abstract

Percutaneous edge-to-edge repair using MitraClip^® (Abbott Laboratories, Abbott Park, IL, USA) can be used to treat mitral regurgitation. However, real-time echocardiographic guidance is vital; and use of 3D transoesophageal echocardiography to guide the procedure has improved reproducibility, reliability and safety. This review describes the MitraClip^® device - which is composed of a steerable guide catheter (SGC) and a Clip Delivery System (CDS) - and the MitraClip^® procedure. The procedure consists of six steps: (1) transseptal approach and puncture; (2) introduction of the SGC into the left atrium; (3) navigation with the CDS into the left atrium to place the MitraClip^® above the mitral valve; (4) crossing the valve and advancing the CDS into the left ventricle; (5) grasping the leaflets and assessment of the quality of the grasping; and (6) final mitral regurgitation assessment. This review also describes which imaging techniques are applicable to each stage of the procedure; and contains examples of the various images obtained during these steps.

Keywords: 2D and 3D imaging; Imagerie 3D; Insuffisance mitrale; MitraClip(®); Mitraclip(®); Mitral regurgitation; Percutaneous edge-to-edge repair; Traitement percutané.

Publication types

Review

MeSH terms

Cardiac Catheterization / adverse effects
Cardiac Catheterization / instrumentation*
Echocardiography, Three-Dimensional*
Echocardiography, Transesophageal*
Heart Valve Prosthesis Implantation / adverse effects
Heart Valve Prosthesis Implantation / instrumentation*
Heart Valve Prosthesis*
Humans
Image Interpretation, Computer-Assisted
Mitral Valve / diagnostic imaging
Mitral Valve / physiopathology
Mitral Valve / surgery*
Mitral Valve Insufficiency / diagnostic imaging
Mitral Valve Insufficiency / physiopathology
Mitral Valve Insufficiency / surgery*
Predictive Value of Tests
Prosthesis Design
Treatment Outcome
Ultrasonography, Interventional / methods*