title: Usefulness of transesophageal echocardiography in percutaneous transcatheter repairs of paravalvular mitral regurgitation.
abstract: This study was conducted to assess the usefulness of transesophageal echocardiography (TEE) as a guide in the percutaneous transcatheter occlusion of paravalvular defects and in subsequent follow-up. In 27 consecutive patients with mitral paravalvular leaks with significant regurgitation considered to be poor surgical candidates who were treated with percutaneous closure of the defects, TEE was performed before and during the procedure. If the device was successfully positioned, a reevaluation was made 1 month later. Events occurring during the procedure and 1-month follow-up were recorded. The device was correctly positioned in 17 of the patients (63%). TEE enabled the detection of complications (intraprosthetic insufficiencies due to passing the guide through the prosthesis, blockade of the prosthesis, etc.). It also confirmed the correct canalization of the leak with the catheter and the position of the device. In 8 patients (47% of patients with successful implantation), the degree of regurgitation was substantially reduced after 1 month. In conclusion, TEE is a fundamental technique when considering the percutaneous treatment of paravalvular leaks in patients with high surgical risk. It provides essential information on the characteristics of the dehiscence during implantation and follow-up.
authors.affiliation: Cardiac Imaging Unit and Hemodynamic Laboratory, Gregorio Marañón General University Hospital, Madrid, Spain.
authors.forename: Marcelino
authors.initials: M
authors.lastname: Cortés
authors.forename: Eulogio
authors.initials: E
authors.lastname: García
authors.forename: Miguel Angel
authors.initials: MA
authors.lastname: García-Fernandez
authors.forename: Jose Juan
authors.initials: JJ
authors.lastname: Gomez
authors.forename: Esther
authors.initials: E
authors.lastname: Perez-David
authors.forename: Francisco
authors.initials: F
authors.lastname: Fernández-Avilés
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization; D017548:Echocardiography, Transesophageal; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000628:therapy*; D011475:Prosthesis Failure