Catheterization and Cardiovascular Interventions 83:303–304 (2014)
Editorial Comment Mitral stenosis following MitraClip procedure: Is it preventable? Mehmet Cilingiroglu,* MD, FSCAI, FACC, FESC Arkansas Heart Hospital/University of Arkansas for Medical Sciences, Little Rock, Arkansas, 72211
During MitraClip procedure, mitral valve area (MVA) and transmitral gradient are typically measured by transesohageal echocardiography (TEE) using the planimetry in the basal transgastric short-axis view as well as right heart catheterization to prevent the development of hemodynamically significant mitral stenosis (MS). The planimetry measurement should be made in mid-diastole; the edges of the MV leaflets should be seen, and each orifice traced and the areas combined to calculate total MVA. Generally MitraClip implantation decreases MVA, with a mean postprocedure MVA of 3.6 6 1.2 cm2 and mitral valve gradient (MVG) of 4.1 6 2.2 mm Hg [1] during resting conditions with no occurrence of clinically significant MS during long term follow up. In this edition of CCI, Cockburn et al. describe the development of MS, 3 months following successful MitraClip implantation. First, as authors pointed out this patient had a borderline MVA of 3.9 cm2 with a heavily calcified annulus and restricted motion of posterior leaflet at baseline and postMitraClip MVA of 1.4 cm2. MitraClip procedure is generally contraindicated in patients with a MVA
Editorial Comment Mitral stenosis following MitraClip procedure: Is it preventable? Mehmet Cilingiroglu,* MD, FSCAI, FACC, FESC Arkansas Heart Hospital/University of Arkansas for Medical Sciences, Little Rock, Arkansas, 72211
During MitraClip procedure, mitral valve area (MVA) and transmitral gradient are typically measured by transesohageal echocardiography (TEE) using the planimetry in the basal transgastric short-axis view as well as right heart catheterization to prevent the development of hemodynamically significant mitral stenosis (MS). The planimetry measurement should be made in mid-diastole; the edges of the MV leaflets should be seen, and each orifice traced and the areas combined to calculate total MVA. Generally MitraClip implantation decreases MVA, with a mean postprocedure MVA of 3.6 6 1.2 cm2 and mitral valve gradient (MVG) of 4.1 6 2.2 mm Hg [1] during resting conditions with no occurrence of clinically significant MS during long term follow up. In this edition of CCI, Cockburn et al. describe the development of MS, 3 months following successful MitraClip implantation. First, as authors pointed out this patient had a borderline MVA of 3.9 cm2 with a heavily calcified annulus and restricted motion of posterior leaflet at baseline and postMitraClip MVA of 1.4 cm2. MitraClip procedure is generally contraindicated in patients with a MVA
