Utility of Real-Time Three-Dimensional Transesophageal Echocardiography in Evaluating the Success of Percutaneous Transcatheter Closure of Mitral Paravalvular Leaks
published online 16 November 2009.
Background
The percutaneous closure of mitral paravalvular leaks has been reported in patients who are poor operative candidates. Unsuccessful percutaneous closure of leaks may be related to morphologic characteristics of the defects.
Methods
Ten patients were selected from a database for mitral dehiscence closure, in whom two-dimensional transesophageal echocardiography revealed inadequate leak closure. Another 4 patients with optimal results were also selected. Real-time three-dimensional transesophageal echocardiography (3DTEE) was performed in all of them.
Results
Real-time 3DTEE enabled the determination of the locations and number of the leaks, as well as their shapes, lengths, widths, areas, and extent. We were also able to observe the position of the device (or devices) implanted during percutaneous closure.
Conclusion
According to this preliminary study, 3DTEE can improve understanding of the causes underlying failure of these techniques to reduce regurgitation secondary to a defect. This could improve patient selection and procedure results, but further studies are needed.
aDepartment of Medicine I, Universidad Complutense de Madrid, Madrid, Spain
bDepartment of Cardiology, Gregorio Marañón General University Hospital, Madrid, Spain
cDepartment of Cardiology, Clinico San Carlos Hospital, Madrid, Spain
Reprint requests: Miguel Angel García-Fernández, Departamento de Medicina I, Facultad de Medicina de la Universidad Complutense, Ciudad Universitaria, Ramon y Cajal s/n, 28040 Madrid, Spain.
ABSTRACT