| Title: |
Mitral bridge width predicts reduction in valve area following for transcatheter edge-to-edge mitral valve repair |
| Authors: |
Thaw, K; Lander, K; Appadurai, V; Lau, K; Murdoch, D; Raffel, C; Walters, D; Scalia, G |
| Source: |
European Heart Journal ; volume 46, issue Supplement_1 ; ISSN 0195-668X 1522-9645 |
| Publisher Information: |
Oxford University Press (OUP) |
| Publication Year: |
2025 |
| Description: |
Background M-TEER is an effective minimally invasive treatment strategy for severe mitral regurgitation (MR). Variations in device sizing and mitral regurgitant anatomy can make predicting mitral valve haemodynamics post M-TEER challenging. Pre-operative valvular gradients and leaflet lengths are useful guides for device choice, however, don’t account for the impact of post TEER device size on residual functional mitral valve area and transvalvular gradients. Objectives This study aimed to assess the relationship between the total width of the M-TEER device "bridge" and subsequent absolute and relative changes in mitral valve area (MVA) (assessed by 3D multiplanar reconstruction (MPR)) and change in the mean pressure gradient (MPG). Methods A retrospective analysis over a 3-year period was conducted on consecutive patients undergoing M-TEER for both degenerative and functional MR from a single-centre quaternary hospital registry. A "mitral bridge width" was defined as the sum width of device clips (as defined by the device company) implanted post M-TEER. Philips Q-LAB version 10.8.5 was utilised for 3D reconstruction and MPR analysis for pre-procedural and post-procedural MVA. Valvular haemodynamics were quantified as per American Society of Echocardiography standardised guidelines. Statistics were performed in Microsoft excel version 16.94. Results A total of 65 patients underwent 66 M-TEER procedures. The mean age was 79 ± 8.2 years, 58.2% male, 42.4% had a left ventricular ejection fraction of >60%. As the mitral bridge width increased, there was a progressive decrease in the 3D MVA. The delta MVA with a bridge width of 4mm or 5mm, 6mm, 10mm and 12mm resulted in a decrease respectively of –1.6 ± 0.6 cm²; –2.8 ± 1.1 cm²; –3.9 ± 1.9 cm²; and –4.0 ± 2.3 cm² (p = 0.008) (Figure 1). When expressed as a percentage of the delta MVA, at a bridge width of 4mm or 5mm, 6mm, 10mm and 12mm there was a relative decrease in the MVA respectively of –37.9 ± 11.2%; –46.3 ± 11.5%; –56.1 ± 14.7%; and –52.5 ± ... |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.1093/eurheartj/ehaf784.135 |
| Availability: |
https://doi.org/10.1093/eurheartj/ehaf784.135; https://academic.oup.com/eurheartj/article-pdf/46/Supplement_1/ehaf784.135/65208634/ehaf784.135.pdf |
| Rights: |
https://academic.oup.com/pages/standard-publication-reuse-rights |
| Accession Number: |
edsbas.601EE937 |
| Database: |
BASE |