mitral regurgitation: updates and mitraclip - mitral regurgitation...30% of patient with chf and up...
TRANSCRIPT
![Page 1: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/1.jpg)
Mitral Regurgitation: Updates and MitraClip©
Ailin Barseghian El-Farra, MD |November 3, 2018
![Page 2: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/2.jpg)
2
Disclosures
None
Cardiology | November 3, 2018
![Page 3: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/3.jpg)
3
MITRAL REGURGITATION GUIDELINES
Cardiology | November 3, 2018
Zoghbi WA, et al. J Am Soc Echocardiogr 2017;30(4):303-371.
![Page 4: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/4.jpg)
4
ANATOMY OF THE MITRAL VALVE
Cardiology | November 3, 2018
Zoghbi WA, et al. J Am Soc Echocardiogr, 2018;30(4):303-371.
Nyman CB, et al. J Am Soc Echocardiogr 2018;31:434-53.
![Page 5: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/5.jpg)
5
PRIMARY vs SECONDARY MITRAL REGURGITATION
Cardiology | November 3, 2018
Zoghbi WA, et al. J Am Soc Echocardiogr 2017;30(4):303-371.
![Page 6: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/6.jpg)
6 Cardiology | November 3, 2018
Nyman CB, et al. J Am Soc Echocardiogr, 2018;31(4):434-53.
![Page 7: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/7.jpg)
7
PROLAPSED LEAFLET
Cardiology | November 3, 2018
![Page 8: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/8.jpg)
8
FLAIL LEAFLET
Cardiology | November 3, 2018
![Page 9: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/9.jpg)
9
BACKGROUND
• Mitral regurgitation is one of the most common valve lesions
• The most common type of mitral regurgitation is primary mitral regurgitation due to myxomatous degeneration, causing leaflet prolapse or flail of the middle scallop of the posterior leaflet.
Cardiology | November 3, 2018
![Page 10: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/10.jpg)
10
CLINICAL RELEVANCE • Moderate MR is present in 6.4% of
population ≥ 65 yo
• Moderate to Severe MR is present in 15-30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI)
• Even asymptomatic patients with severe MR have higher 5 year rates of death, HF and atrial fibrillation
Cardiology | November 3, 2018
Rogers JH, et al. European Heart Journal 2011;32:2350-2357.
![Page 11: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/11.jpg)
11
CASE
Cardiology | November 3, 2018
![Page 12: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/12.jpg)
12
CASE
Cardiology | November 3, 2018
![Page 13: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/13.jpg)
13
CASE
Cardiology | November 3, 2018
![Page 14: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/14.jpg)
14
CASE
Cardiology | November 3, 2018
![Page 15: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/15.jpg)
15 Cardiology | November 3, 2018
CASE
![Page 16: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/16.jpg)
16
OPERATIVE REPORT Findings:
• Severe bileaflet myxomatous mitral valve changes. Ruptured primary chord of medial aspect of P1 causing prolapse but also prolapsing P2 segment of posterior leaflet of mitral valve
Operation:
• Minimally invasive mitral valve repair via right thoracotomy approach
• P2 triangular resection
• 34mm Medtronic Future Band annuloplasty Ring
Pathology of Mitral Valve P2 tissue:
• Valvular tissue with myxoid degeneration
Cardiology | November 3, 2018
![Page 17: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/17.jpg)
17 Cardiology | November 3, 2018
![Page 18: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/18.jpg)
18
MITRAL VALVE CLEFT
• A 16 year old female with a history of ostium primum atrial septal defect (ASD) and cleft anterior mitral valve repair at 14 months of age was being followed with echocardiography for residual postoperative mitral regurgitation.
• Over the past year, she developed cough and decreased exercise tolerance.
• Auscultation revealed a high frequency, holosystolic murmur with II/VI intensity harshest at the apex.
Cardiology | November 3, 2018
![Page 19: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/19.jpg)
Intra-operative transesophageal echocardiogram confirmed the centrally directed severe mitral regurgitation jet.
Real-time 3D transesophageal echocardiogram demonstrated a large cleft in the anterior mitral leaflet (another cleft of the posterior leaflet)
Cardiology | November 3, 2018
Barseghian, et al. J Thorac and Cardiovasc Surg, 2012;143(2):503-4.
CASE
![Page 20: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/20.jpg)
20
Robot-Assisted Surgical Correction of Dual Mitral Valve Clefts
Cardiology | November 3, 2018
Barseghian, et al. J Thorac and Cardiovasc Surg, 2012;143(2):503-4.
POSTERIOR MITRAL VALVE CLEFT
![Page 21: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/21.jpg)
CASE: POST-OPERATIVE TEE
Cardiology | November 3, 2018
![Page 22: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/22.jpg)
22
SECONDARY or “FUNCTIONAL” MITRAL REGURGITATION
Cardiology | November 3, 2018
Capoulade R, et al. J Thorac Dis 2017;9(Suppl 7):S640-S660.
![Page 23: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/23.jpg)
MITRAL REGURGITATION SEVERITY
Cardiology | November 3, 2018
![Page 24: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/24.jpg)
24
MITRAL REGURGITATION SEVERITY
Cardiology | November 3, 2018
Zoghbi WA, et al. J Am Soc Echocardiogr 2017;30(4):303-371.
![Page 25: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/25.jpg)
25
MITRAL REGURGITATION GRADING ALGORHYTHM
Cardiology | November 3, 2018
www.asecho.org/vrcases Zoghbi WA, et al. J Am Soc Echocardiogr 2017;30(4):303-371.
![Page 26: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/26.jpg)
26
QUALITATIVE PARAMETERS
Cardiology | November 3, 2018
Zoghbi WA, et al. J Am Soc Echocardiogr 2017;30(4):303-371.
![Page 27: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/27.jpg)
27
SEMIQUANTITATIVE
Cardiology | November 3, 2018
Ender J, et al. Ann Cardiothorac Surg 2013;2(6):796-802.
![Page 28: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/28.jpg)
28 Cardiology | November 3, 2018
Quantification of Regurgitation by EROA, 2D PISA
Zoghbi WA, et al. J Am Soc Echocardiogr 2017;30(4):303-371.
![Page 29: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/29.jpg)
29
MITRAL REGURGITATION QUANTIFICATION
Cardiology | November 3, 2018
![Page 30: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/30.jpg)
30 Cardiology | November 3, 2018
![Page 31: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/31.jpg)
31 Cardiology | November 3, 2018
Zoghbi, et al. JASE, Apr 2017
![Page 32: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/32.jpg)
32
Mitral Regurgitation Continuous Wave (CW) Doppler
Cardiology | November 3, 2018
![Page 33: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/33.jpg)
33 Cardiology | November 3, 2018
![Page 34: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/34.jpg)
34 Cardiology | November 3, 2018
![Page 35: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/35.jpg)
35 Cardiology | November 3, 2018
![Page 36: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/36.jpg)
36
Mitral Regurgitation Assessment: ASE Guidelines Principles
1. Measure every component of mitral regurgitation
2. Quantify mitral regurgitation 3. Severe and moderate mitral regurgitation
-> important
Cardiology | November 3, 2018
![Page 37: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/37.jpg)
37 Cardiology | November 3, 2018
![Page 38: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/38.jpg)
MITRAL REGURGITATION MANAGEMENT WITH TRANSCATHETER EDGE-TO-EDGE CLIP
Cardiology | November 3, 2018
AKA: MITRACLIP©
![Page 39: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/39.jpg)
39
MITRACLIP DEVICE
MitraClip device (Abbot Vascular Structural Heart, Menlo Park, CA, USA) Image Adapted from UW Medicine
![Page 40: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/40.jpg)
40
Mitral Regurgitation – Decision Pathway
Cardiology | November 3, 2018
JACC 2017
![Page 41: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/41.jpg)
41
ROLE of ECHO IMAGING BEFORE TRANSCATHETER MV PROCEDURES
Cardiology | November 3, 2018
MacKensen, et al. JASE April 2018
![Page 42: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/42.jpg)
42
TTE in Mitral Valve Assessment
Cardiology | November 3, 2018
Nyman CB, et al. JASE, 2018;31 (4):434-53.
![Page 43: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/43.jpg)
43
TEE
Cardiology | November 3, 2018
Transgastric 2 Chamber Basal Short Axis
Midesophageal 4 Chamber Mitral Commissural
2 Chamber Long Axis
Ender J, et al. Ann Cardiothorac Surg 2013;2(6): 796-802.
![Page 44: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/44.jpg)
44
3D “SURGICAL VIEW”
Cardiology | November 3, 2018
Delgado V, et al. Eur Heart J Suppl 2010;12:E10-E23
![Page 45: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/45.jpg)
45 Cardiology | November 3, 2018
Rogers JH, et al. European Heart Journal 2011;32:2350-2357.
![Page 46: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/46.jpg)
46
EDGE-TO-EDGE MITRACLIP THERAPY
Cardiology | November 3, 2018
MitraClip can be used to approximate leaflets at different locations along the leaflet coaptation surface.
![Page 47: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/47.jpg)
47
ALFIERI STICH
Cardiology | November 3, 2018
Alfieri O. (2015) The Genesis of the Edge-to-Edge Technique. In: Alfieri O., De Bonis M., La Canna G. (eds) Edge-to-Edge Mitral Repair. Springer, Cham
![Page 48: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/48.jpg)
48
MitraClip
Cardiology | November 3, 2018
Delgado V, et al. Eur Heart J Suppl 2010;12:E10-E23.
![Page 49: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/49.jpg)
49
Intra-atrial septum variations
Cardiology | November 3, 2018
Atrial Septal Aneurysm
Lipomatous Hypertrophy
Tugue, et al. JASE 2007
![Page 50: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/50.jpg)
50 Cardiology | November 3, 2018
JASE 2018:31;434
ROLE OF ECHO in ASSESSING INTRA-ATRIAL SEPTUM
![Page 51: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/51.jpg)
51 Cardiology | November 3, 2018
![Page 52: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/52.jpg)
52
TRANSEPTAL PUNCTURE
Cardiology | November 3, 2018 Adapted from UW Medicine
![Page 53: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/53.jpg)
53 Cardiology | November 3, 2018
![Page 54: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/54.jpg)
54
SUMMARY
• Echocardiography is key to determining mitral valve pathology
• Echocardiography is invaluable for MitraClip procedural guidance, confirming success, and exclusion of complications.
• Interventional echocardiography will increase with the development of new devices.
Cardiology | November 3, 2018
![Page 55: Mitral Regurgitation: Updates and MitraClip - Mitral Regurgitation...30% of patient with CHF and up to 12% of patients within 1 month of myocardial infarction (MI) ... the anterior](https://reader033.vdocuments.us/reader033/viewer/2022041718/5e4cbc13eaf27457476b747c/html5/thumbnails/55.jpg)
THANK YOU
Cardiology | November 3, 2018