First-in-Human Use of Intravascular Lithotripsy to Facilitate Mitral Balloon Commissurotomy After Prior Annuloplasty Band Repair

Figures

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  Figure 1. Transthoracic Echocardiography Showing Mitral Valve Area of 0.59 cm2 by Velocity Time Integral

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  Figure 2. Transesophageal Echocardiography Showing Severe Mitral Calcification and Leaflet Immobility

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  Figure 3. Transesophageal Echocardiography Showing Mean Mitral Valve Gradient 11 mm Hg at 79 beats/min

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  Figure 4. Transesophageal Echocardiography Showing Mitral Valve Area 0.51 cm2 by Planimetry

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  Figure 5. Right Heart Catheterization With Pulmonary Capillary Wedge Pressure 32 mm Hg and Transmitral Gradient of ∼18 mm Hg

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  Figure 6. Gated Cardiac Computed Tomography With Mitral Annular Dimensions 2 × 1.8 cm

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  Figure 7. Cineangiography of Percutaneous Mitral Balloon Commissurotomy With 20-mm True Balloon

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  Figure 8. Postprocedural MV Gradients on Transesophageal Echocardiography (A) MV gradient after IVL with improvement to 5.8 mm Hg. (B) Similar gradients after PMBC. IVL = intravascular lithotripsy; MV = mitral valve; PMBC = percutaneous mitral balloon commissurotomy.

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  Figure 9. Improvement in 3-Dimensional Mitral Valve Area to 1.9 cm2

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  Figure 10. Mild Mitral Regurgitation

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  Figure 11. Postprocedural Pulmonary Capillary Wedge Pressure Improved to 25 mm Hg With Estimated Transmitral Gradient ∼12 mm Hg