Invasive Hemodynamic Assessment During Mitra-Clip Implantation: Should It Be the New Standard?

Transesophageal echocardiography (TEE) assessment after MitraClip implantation is limited by unequal orifices and jets, eccentric regurgitation, and the acute change of the annulus geometry. Periprocedural real-time invasive hemodynamic assessment of the mitral valve function requires experience in hemodynamic monitoring interpretation. However, it provides excellent accuracy as it does not take into account the changes of the mitral apparatus geometry and jet direction after MitraClip placement. While we seek to expand indications of Mitraclip to other patient subgroups, we should consider routine ancillary invasive hemodynamic assessment, in order to optimize our understanding, procedural results.