Usefulness of Transesophageal Echocardiography in Percutaneous Transcatheter Repairs of Paravalvular Mitral Regurgitation

• Published in: The American journal of cardiology 2008-02, Vol.101 (3), p.382-386
• Main Authors: Cortés, Marcelino, MD, García, Eulogio, MD, García-Fernandez, Miguel Angel, PhD, Gomez, Jose Juan, MD, Perez-David, Esther, MD, Fernández-Avilés, Francisco, PhD
• Format: Article
• Language: English
• Subjects: Aged; Biological and medical sciences; Cardiac Catheterization; Cardiology; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Cardiovascular system; Catheters; Echocardiography, Transesophageal; Endocardial and cardiac valvular diseases; Female; Heart; Heart Valve Prosthesis; Humans; Investigative techniques, diagnostic techniques (general aspects); Male; Medical sciences; Middle Aged; Mitral Valve Insufficiency - diagnostic imaging; Mitral Valve Insufficiency - therapy; Prosthesis Failure; Studies; Transplants & implants; Ultrasonic imaging; Ultrasonic investigative techniques
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2007.08.052

This study was conducted to assess the usefulness of transesophageal echocardiography (TEE) as a guide in the percutaneous transcatheter occlusion of paravalvular defects and in subsequent follow-up. In 27 consecutive patients with mitral paravalvular leaks with significant regurgitation considered to be poor surgical candidates who were treated with percutaneous closure of the defects, TEE was performed before and during the procedure. If the device was successfully positioned, a reevaluation was made 1 month later. Events occurring during the procedure and 1-month follow-up were recorded. The device was correctly positioned in 17 of the patients (63%). TEE enabled the detection of complications (intraprosthetic insufficiencies due to passing the guide through the prosthesis, blockade of the prosthesis, etc.). It also confirmed the correct canalization of the leak with the catheter and the position of the device. In 8 patients (47% of patients with successful implantation), the degree of regurgitation was substantially reduced after 1 month. In conclusion, TEE is a fundamental technique when considering the percutaneous treatment of paravalvular leaks in patients with high surgical risk. It provides essential information on the characteristics of the dehiscence during implantation and follow-up.