Single-Center Experience of Omitting Preprocedure Transesophageal Echo for MitraClip Patients

Area of Science:

• Cardiovascular Medicine
• Medical Imaging
• Interventional Cardiology

Background:

• Mitral transcatheter edge-to-edge repair (TEER) is a crucial intervention for mitral valve disease.
• Preprocedure echocardiography is essential for planning and guiding TEER procedures.
• Timeliness of transesophageal echocardiography (TEE) can be a logistical challenge in certain clinical scenarios.

Purpose of the Study:

• To evaluate the feasibility and outcomes of performing mitral TEER using transthoracic echocardiography (TTE) when TEE is not timely.
• To determine if TTE-guided TEER compromises safety, procedural success, or valve function.
• To assess the impact of utilizing TTE in lieu of TEE on patient outcomes.

Main Methods:

• Retrospective analysis of patients undergoing mitral TEER.
• Comparison of outcomes between patients who had TEER guided by TEE versus TTE.
• Assessment of procedural success, device deployment, and immediate post-procedure valve function.
• Evaluation of safety endpoints including major adverse events.

Main Results:

• Mitral TEER can be successfully performed using transthoracic echocardiography (TTE) in cases where transesophageal echocardiography (TEE) is delayed.
• No significant differences were observed in safety, procedural success, or valve outcomes between TEE-guided and TTE-guided TEER.
• Heart teams can confidently proceed with TEER using TTE data, ensuring timely intervention without compromising patient care.

Conclusions:

• Transthoracic echocardiography is a viable alternative imaging modality for guiding mitral TEER when TEE is not readily available.
• Utilizing TTE does not adversely affect the safety or efficacy of mitral TEER.
• This finding expands the procedural options for mitral TEER, improving patient access to timely treatment.