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Updated: May 14, 2026
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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Mitral valve repair using multiple MitraClips®: a dobutamine stress echocardiography evaluation
Liliya Paranskaya1, Giuseppe D'Ancona, Ilkay Bozdag-Turan
1Heart Center Rostock, University Hospital Rostock, Rostock, Germany.
Summary
Mitral valve repair with multiple MitraClips® shows stable residual mitral regurgitation during stress. Transmitral pressure gradient increases but remains non-pathological, indicating good hemodynamic performance.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Echocardiography
Background:
- Mitral valve (MV) repair using multiple MitraClips® (MC) is a common procedure.
- The hemodynamic performance of MV repair with MC under stress has not been well-investigated.
Purpose of the Study:
- To evaluate the stress performance of MV repair using multiple MitraClips®.
- To assess hemodynamic changes and mitral valve function during dobutamine stress echocardiography after MC implantation.
Main Methods:
- Twenty patients who received >2 MitraClips® underwent dobutamine stress echocardiography (DSE).
- Hemodynamic parameters including transmitral pressure gradient (TPG) and mitral valve orifice area (MVOA) were measured.
- Left ventricular ejection fraction (LVEF) and pulmonary artery pressure were also assessed.
Main Results:
- Mean TPG and MVOA significantly increased during DSE, showing physiological behavior.
- LVEF and systolic pulmonary artery pressure increased significantly.
- The degree of mitral regurgitation (MR) remained stable during stress (p=0.68).
Conclusions:
- Mitral valve repair with MitraClips® should aim for maximal MR reduction.
- MV repair with MC does not appear to cause pathological MV stenosis.
- Increased TPG during stress is physiological and accompanied by increased MVOA; residual MR is stable.
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