Key procedural techniques for transcatheter mitral valve edge-to-edge repair_West China Medical Journal

Authors：

LU Zhinan ¹ , KE Yutong ² , WU Wenhui ¹ , LIU Xinmin ¹ ,  SONG Guangyuan ¹

1. Interventional Center of Valvular Heart Disease Center, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P. R. China;
2. Department of Echocardiography, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, P. R. China;

Corresponding author：

SONG Guangyuan, Email: songgy_anzhen@VIP.163.com

Keywords：

Transcatheter mitral valve edge-to-edge repair; mitral regurgitation; operation techniques

DOI：

10.7507/1002-0179.202211118

Video：

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Transcatheter mitral valve edge-to-edge repair (TEER) has become an essential treatment option for patients with severe mitral regurgitation at high or prohibitive surgical risk. However, the surgical devices and procedural steps of the surgery are intricate, and there is currently a lack of standardized TEER procedures in China. Based on existing evidence and the accumulated experience in clinical practice, this article briefly introduces the definition, indications, contraindications, and surgical devices of TEER. It also provides a systematic and detailed elaboration on the procedural steps, key technical points, complications, and their management measures, offering guidance for the standardized implementation and widespread adoption of TEER in clinical practice in China.

Citation： LU Zhinan, KE Yutong, WU Wenhui, LIU Xinmin, SONG Guangyuan. Key procedural techniques for transcatheter mitral valve edge-to-edge repair. West China Medical Journal, 2023, 38(9): 1288-1296. doi: 10.7507/1002-0179.202211118 Copy

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3.	Writing Committee Members, Otto CM, Nishimura RA, et al. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol, 2021, 77(4): e25-e197.
4.	Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J, 2022, 43(7): 561-632.
5.	中华医学会心血管病学分会. 经导管二尖瓣缘对缘修复术的中国专家共识. 中华心血管病杂志, 2022, 50(9): 853-863.
6.	Alkhouli M, Rihal CS, Holmes DR. Transseptal techniques for emerging structural heart interventions. JACC Cardiovasc Interv, 2016, 9(24): 2465-2480.
7.	Singh GD, Smith TW, Rogers JH. Targeted transseptal access for MitraClip percutaneous mitral valve repair. Interv Cardiol Clin, 2016, 5(1): 55-69.
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9.	Roelke M, Smith AJ, Palacios IF. The technique and safety of transseptal left heart catheterization: the Massachusetts General Hospital experience with 1, 279 procedures. Cathet Cardiovasc Diagn, 1994, 32(4): 332-339.
10.	Lurz P, Unterhuber M, Rommel KP, et al. Closure of iatrogenic atrial septal defect after transcatheter mitral valve repair: the randomized MITHRAS trial. Circulation, 2021, 143(3): 292-294.
11.	Singh GD, Rogers JH, Chen S, et al. Adjunctive use of fluoroscopy during MitraClip implantation reduces procedural complexity: the parallax technique. Catheter Cardiovasc Interv, 2021, 97(4): 745-754.
12.	潘翠珍, 潘文志, 周达新, 等. 二尖瓣经导管缘对缘修复的超声心动图操作规范中国专家共识. 中国介入心脏病学杂志, 2022, 30(10): 721-733.

1. 张斌, 许海燕, 高润霖, 等. 中国老年瓣膜性心脏病不同性别住院患者的流行病学特点: 一项全国性多中心横断面研究. 中国医刊, 2020, 55(1): 26-30.
2. Condado JA, Acquatella H, Rodriguez L, et al. Percutaneous edge-to-edge mitral valve repair: 2-year follow-up in the first human case. Catheter Cardiovasc Interv, 2006, 67(2): 323-325.
3. Writing Committee Members, Otto CM, Nishimura RA, et al. 2020 ACC/AHA Guideline for the Management of Patients With Valvular Heart Disease: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol, 2021, 77(4): e25-e197.
4. Vahanian A, Beyersdorf F, Praz F, et al. 2021 ESC/EACTS Guidelines for the management of valvular heart disease. Eur Heart J, 2022, 43(7): 561-632.
5. 中华医学会心血管病学分会. 经导管二尖瓣缘对缘修复术的中国专家共识. 中华心血管病杂志, 2022, 50(9): 853-863.
6. Alkhouli M, Rihal CS, Holmes DR. Transseptal techniques for emerging structural heart interventions. JACC Cardiovasc Interv, 2016, 9(24): 2465-2480.
7. Singh GD, Smith TW, Rogers JH. Targeted transseptal access for MitraClip percutaneous mitral valve repair. Interv Cardiol Clin, 2016, 5(1): 55-69.
8. Yap J, Chen S, Stripe BR, et al. Transseptal access for left heart structural interventions in the setting of prior atrial septal defect closure. Catheter Cardiovasc Interv, 2020, 95(3): 414-419.
9. Roelke M, Smith AJ, Palacios IF. The technique and safety of transseptal left heart catheterization: the Massachusetts General Hospital experience with 1, 279 procedures. Cathet Cardiovasc Diagn, 1994, 32(4): 332-339.
10. Lurz P, Unterhuber M, Rommel KP, et al. Closure of iatrogenic atrial septal defect after transcatheter mitral valve repair: the randomized MITHRAS trial. Circulation, 2021, 143(3): 292-294.
11. Singh GD, Rogers JH, Chen S, et al. Adjunctive use of fluoroscopy during MitraClip implantation reduces procedural complexity: the parallax technique. Catheter Cardiovasc Interv, 2021, 97(4): 745-754.
12. 潘翠珍, 潘文志, 周达新, 等. 二尖瓣经导管缘对缘修复的超声心动图操作规范中国专家共识. 中国介入心脏病学杂志, 2022, 30(10): 721-733.

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