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Updated: Jan 10, 2026
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A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
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Transesophageal Echocardiography in Transcatheter Mitral Valve Replacement
Beatrice Bacchi1, Kendra Derry2, Tasnim Vira3
1Division of Cardiac Surgery, St. Michael's Hospital, University of Toronto, 36 Queen Street E, Toronto, ON M5B 1W8, Canada.
Journal of Clinical Medicine
|November 27, 2025
Summary
Transesophageal echocardiography (TEE) is crucial for transcatheter mitral valve replacement (TMVR). This review details TEE best practices for patient assessment, procedural guidance, and surveillance to improve TMVR outcomes.
Area of Science:
- Cardiology and Cardiovascular Imaging
Background:
- Transcatheter mitral valve replacement (TMVR) is a complex procedure requiring precise imaging.
- Transesophageal echocardiography (TEE) has become indispensable for TMVR procedures.
Purpose of the Study:
- To review the role and best practices of TEE in all stages of TMVR.
- To consolidate current consensus, quantitative thresholds, and device-specific TEE considerations.
- To highlight evolving TEE technologies for TMVR.
Main Methods:
- Review of recent consensus statements and literature on TEE in TMVR.
- Analysis of quantitative thresholds and device-specific recommendations.
- Discussion of multimodality imaging integration and Heart Team approach.
Main Results:
- TEE is vital for patient assessment, device selection, intraprocedural guidance, and post-implant surveillance in TMVR.
- Real-time TEE insights aid in understanding valve anatomy, hemodynamics, and potential complications.
- The review provides a roadmap for optimizing TEE integration in TMVR workflows.
Conclusions:
- TEE is the pivotal imaging modality for successful TMVR.
- Adherence to best practices and integration of TEE into multimodality workflows optimizes patient outcomes.
- Clinicians benefit from this comprehensive guide for enhanced TMVR procedures.
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