Authors:	Geyer, Martin Sotiriou, Efthymios Keller, Karsten Tamm, Alexander R. Ruf, Tobias F. Kreidel, Felix Beiras-Fernandez, Andres Kornberger, Angela Yang, Yang Emrich, Tilman Schulz, Eberhard Münzel, Thomas Bardeleben, Ralph Stephan von
Title:	Feasibility of a MPR-based 3DTEE guidance protocol for transcatheter direct mitral valve annuloplasty
Online publication date:	16-Aug-2021
Year of first publication:	2020
Language:	english
Abstract:	OBJECTIVES Several interventional approaches have been established for the treatment of severe mitral regurgitation (MR) in patients at elevated risk for surgery. Direct annuloplasty is a relatively novel option in transcatheter mitral valve repair dedicated to reverse pathology in specific subsets of MR. With regard to echocardiographic guidance, this procedure presents with higher efforts in comparison with edge-to-edge therapy to enable safe and exact positioning of the device's anchors; evidence on optimal peri-interventional imaging is sparse. We tested a specific 3D-echo-guidance protocol implementing single-beat multiplanar reconstruction (MPR) and evaluated its feasibility. METHODS Overall, 16 patients consecutively treated with transcatheter direct annuloplasty for severe MR (87.5% functional/6.3% degenerative/6.3% mixed pathology) were entered in this monocentric analysis. Of these, two patients received a combined procedure including edge-to-edge repair. For all implantations, a 3D-echo-guidance protocol inheriting MPR was employed. RESULTS Periprocedural device time decreased continuously (overall mean 140 ± 55.1 minutes, 213 ± 38 minutes in the first 4 vs 108 ± 33 minutes in the last 4 procedures, P = .018) using the MPR-based echo protocol, going along with reduced fluoroscopy times and doses. Technical success rate was high (93.8%) without any serious cardiac-related adverse events. MR could be relevantly improved. CONCLUSION Echocardiographic guidance of transcatheter direct annuloplasty using a real time MPR-based protocol is feasible and safe. Optimized imaging might enable reduced implantation times and potentially increases safety.
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-6282
Version:	Published version
Publication type:	Zeitschriftenaufsatz
License:	CC BY
Information on rights of use:	https://creativecommons.org/licenses/by/4.0/
Journal:	Echocardiography 37 9
Pages or article number:	1436 1442
Publisher:	Wiley-Blackwell
Publisher place:	Oxford u.a.
Issue date:	2020
ISSN:	1540-8175
Publisher URL:	https://doi.org/10.1111/echo.14694
Publisher DOI:	10.1111/echo.14694
Appears in collections:	JGU-Publikationen