Related Experiment Video

Updated: Dec 10, 2025

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
08:31

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair

Published on: October 16, 2021

4.2K

Transcatheter mitral valve in ring, hazards of long anterior mitral leaflet and 3-dimensional rings

Nishant Sekaran1, Benjamin D Horne1,2, John R Doty1

  • 1Intermountain Heart Institute, Salt Lake City, Utah.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions
|September 1, 2020
PubMed
Abstract

Insights

Anterior mitral leaflet length over 25 mm is a risk factor for left ventricular outflow tract obstruction after transcatheter mitral valve-in-ring procedures. Parvalvular leak is common, especially with 3D rings.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Transcatheter Mitral Valve-in-Ring (MViR) procedures carry risks of parvalvular leak (PVL) and left ventricular outflow tract (LVOT) obstruction.
  • These complications can impact procedural success and patient outcomes.

Purpose of the Study:

  • To identify anterior mitral leaflet (AML) length and mitral ring characteristics associated with LVOT obstruction and PVL after MViR.
  • To define risk factors for MViR complications.

Main Methods:

  • Retrospective review of clinical records, CT scans, and echocardiograms in MViR patients.
  • Analysis of AML length, CT-simulated neoLVOT, and aortomitral angle in patients with and without LVOT obstruction.

Main Results:

  • Anterior mitral leaflets were significantly longer in patients who developed LVOT obstruction (30 mm TEE, 29 mm CT) compared to those who did not (21 mm TEE, 22 mm CT).
  • An AML length greater than 25 mm was associated with an increased risk of MViR-induced LVOT obstruction.
  • PVL was frequent, particularly with 3-dimensional rings, often requiring a second transcatheter heart valve (THV).

Conclusions:

  • Anterior mitral leaflet length exceeding 25 mm is a predictor of MViR-induced LVOT obstruction.
  • Parvalvular leak is a common complication of MViR, especially with 3D rings, and can be managed with a second THV.
Keywords:
mitral valve diseaseparavalvular leakpercutaneous interventiontranscatheter valve implantation

More Related Videos

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels08:12

Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels

Published on: May 26, 2023

2.0K
An Image Guided Transapical Mitral Valve Leaflet Puncture Model of Controlled Volume Overload from Mitral Regurgitation in the Rat07:42

An Image Guided Transapical Mitral Valve Leaflet Puncture Model of Controlled Volume Overload from Mitral Regurgitation in the Rat

Published on: May 19, 2020

7.4K

Related Concept Videos

Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

Mitral stenosis, a condition marked by the narrowing of the mitral valve, necessitates an integrated approach for effective management. This approach includes preventative measures, medical therapy, and surgical interventions to reduce symptoms and prevent complications.PreventionPrevention of mitral stenosis primarily focuses on reducing the incidence of bacterial infections, particularly streptococcal infections, which can lead to rheumatic fever and subsequent valvular damage. Timely...
149
Mitral Valve Prolapse I: Introduction01:27

Mitral Valve Prolapse I: Introduction

IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
209
Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

Mitral regurgitation (MR) is characterized by retrograde blood circulation from the left ventricle into the left atrium due to inadequate mitral valve closure. The severity of the condition, symptoms, and underlying cause determine treatment strategies.Monitoring and Pharmacological TreatmentPatients with mild to moderate MR typically do not need immediate intervention but regular monitoring to assess progression and guide treatment. Patients with mild MR should have an echocardiogram every 3-5...
169
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
215
Mitral Regurgitation I: Introduction01:20

Mitral Regurgitation I: Introduction

Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
235
Mitral Valve Prolapse III: Nursing Management01:19

Mitral Valve Prolapse III: Nursing Management

The nursing management of Mitral Valve Prolapse, or MVP, centers around patient education, symptom monitoring, and lifestyle modifications.Patient Education on MVP Diagnosis and Heredity: Nurses should provide comprehensive education about MVP, a condition where the mitral valve does not close appropriately during heartbeats. This education often includes the condition's pathophysiology, symptoms, and potential complications, like arrhythmias or mitral regurgitation. Though not fully...
157