Transcatheter Mitral Valve Repair for an Extremely High Surgical Risk Acute Mitral Regurgitation Patient

Figures

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  Figure 1. Transesophageal Echocardiography Before Procedure (A, B) Two-dimensional transesophageal echocardiography shows anterior leaflet prolapse (A2-P2 region) with severe mitral regurgitation before procedure. (C) Three-dimensional transesophageal echocardiography before procedure. The blue arrow indicates the prolapsing anterior leaflet and the yellow arrow indicates the papillary muscle connecting to the leaflet. (D) Three-dimensional transesophageal echocardiography shows severe mitral valve regurgitation.

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  Figure 2. Lengths of Papillary Muscles, Anterior Leaflet, and Posterior Leaflet

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  Figure 3. Procedural Steps of Mitral Valve Repair (A, B) 2 and 3-dimensional transesophageal echocardiography shows the clip at the right position with appropriate orientation. (C, D) X-plane shows mitral valve regurgitation significantly improved when the clip was closed. (E, F) 3 dimensional transesophageal echocardiography shows that the clip is stable with tissue bridge and mitral valve regurgitation reduced to mild.

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  Figure 4. Pulmonary Venous Blood Flow Doppler Spectrum (A) Left pulmonary vein systolic flow reversal before the procedure. (B) Left pulmonary vein systolic flow reversal before the procedure. (C) Left pulmonary vein systolic flow reversal after release of the mitral clamp. (D) Left pulmonary vein systolic flow reversal after release of the mitral clamp.