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Related Concept Videos

Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

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Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
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Mitral Regurgitation III: Medical Management01:25

Mitral Regurgitation III: Medical Management

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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...
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Mitral Stenosis III: Medical Management01:26

Mitral Stenosis III: Medical Management

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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...
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Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

34
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...
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Mitral Valve Prolapse II: Assessment and Management01:22

Mitral Valve Prolapse II: Assessment and Management

39
IntroductionA range of clinical features characterizes Mitral Valve Prolapse (MVP), but it is important to note that many individuals with MVP are asymptomatic and may remain so throughout their lives. For those who do exhibit symptoms, the following are the key clinical features:Palpitations: This is a common symptom where individuals feel an irregular or rapid heartbeat. Palpitations in MVP are often due to arrhythmias such as premature ventricular contractions or supraventricular...
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Mitral Valve Prolapse I: Introduction01:27

Mitral Valve Prolapse I: Introduction

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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...
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Related Experiment Video

Updated: Sep 9, 2025

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
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Acute Changes in Mitral Annular Geometry After Transcatheter Edge-to-Edge Repair With PASCAL.

Konstantinos Papadopoulos1,2, Michael Chrissoheris1, Dionysios Aravantinos1

  • 1Transcatheter Heart Valves Department, HYGEIA Hospital, Athens, Greece.

Echocardiography (Mount Kisco, N.Y.)
|August 28, 2025
PubMed
Summary

Transcatheter edge-to-edge mitral valve repair (TEER) using the PASCAL device significantly reduces mitral annular dimensions, leading to a more elliptical valve shape. This acute change correlates with improved and sustained mitral regurgitation reduction.

Keywords:
3D echocardiographyMVQ analysisMitral‐TEERPASCAL devicemitral regurgitationtranscatheter interventions

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Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Echocardiography

Background:

  • Transcatheter edge-to-edge mitral valve repair (TEER) is a safe and effective treatment for high-risk patients with severe mitral regurgitation (MR).
  • Devices like PASCAL approximate mitral valve leaflets to reduce MR and may alter annular dimensions.
  • Understanding acute annular changes post-PASCAL implantation is crucial for long-term outcomes.

Purpose of the Study:

  • To analyze acute mitral annular dimensional changes after PASCAL device implantation.
  • To correlate these annular changes with long-term clinical results in patients with MR.

Main Methods:

  • Retrospective analysis of 115 high-risk patients with moderate-to-severe or severe MR.
  • Intraprocedural transesophageal echocardiography (TOE) data analyzed for mitral annular geometry.
  • Assessment of annular dimensions, area, perimeter, and ellipticity before and after PASCAL implantation.

Main Results:

  • PASCAL implantation effectively reduced MR severity in all patients.
  • Significant acute reductions observed in 3D mitral annular area (7.1%) and perimeter (3.2%) post-TEER.
  • Anterior-posterior diameter reduction was more pronounced than medial-lateral, leading to increased valve ellipticity.
  • Annular dimension reduction correlated with residual MR at discharge and long-term echocardiographic outcomes.

Conclusions:

  • TEER with the PASCAL device acutely reduces mitral annular dimensions and increases ellipticity.
  • These acute geometric changes are associated with sustained improvement in mitral regurgitation.
  • PASCAL implantation offers a promising approach for managing severe MR in high-risk patients.