Echocardiography-guided transseptal mitral valve replacement: a case report_West China Medical Journal

Authors：

WEI Xin , LI Xi , ZHAO Zhengang , CHEN Fei , TANG Hong , FENG Yuan , CHEN Mao ,  LIANG Yujia

Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LIANG Yujia, Email: 2587579440@qq.com

Keywords：

Mitral regurgitation; echocardiography; transcatheter mitral valve replacement

DOI：

10.7507/1002-0179.202408152

Video：

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In recent years, transcatheter mitral valve replacement is a focused issue in the field of valve intervention, which brings hope to mitral regurgitation patients who are not suitable for surgical thoracotomy. This paper presents the case of echocardiography-guided transseptal mitral valve replacement with the HighLife system in an elderly female patient with severe mitral regurgitation who failed to respond to standard medical therapy. During the procedure, echocardiography was used to guide the wire looping, cinching, atrial septal puncture, ring closure, atrial septal balloon dilatation, prosthetic valve implantation and immediate postoperative evaluation. Echocardiography plays an important role in transseptal mitral valve replacement, which can help the procedural process and improve the safety of the procedure.

Citation： WEI Xin, LI Xi, ZHAO Zhengang, CHEN Fei, TANG Hong, FENG Yuan, CHEN Mao, LIANG Yujia. Echocardiography-guided transseptal mitral valve replacement: a case report. West China Medical Journal, 2024, 39(9): 1366-1370. doi: 10.7507/1002-0179.202408152 Copy

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2.	Iung B, Delgado V, Rosenhek R, et al. Contemporary presentation and management of valvular heart disease: the EURobservational research programme valvular heart disease Ⅱ Survey. Circulation, 2019, 140(14): 1156-1169.
3.	Iung B, Delgado V, Lazure P, et al. Educational needs and application of guidelines in the management of patients with mitral regur- gitation. A European mixed-methods study. Eur Heart J, 2018, 39(15): 1295-1303.
4.	Mirabel M, Iung B, Baron G, et al. What are the characteristics of patients with severe, symptomatic, mitral regurgitation who are denied surgery?. Eur Heart J, 2007, 28(11): 1358-1365.
5.	Gheorghe LL, Mobasseri S, Agricola E, et al. Imaging for native mitral valve surgical and transcatheter interventions. JACC Cardiovasc Imaging, 2021, 14(1): 112-127.
6.	Urena M, Lurz P, Sorajja P, et al. Transcatheter mitral valve implantation for native valve disease. EuroIntervention, 2023, 19(9): 720-738.
7.	Lange R, Piazza N. HighLife transcatheter mitral valve replacement. EuroIntervention, 2016, 12(Y): Y81-Y83.
8.	陈飞, 赵振刚, 姚怡君, 等. 经房间隔途径经导管二尖瓣置换术治疗严重二尖瓣反流的可行性和安全性. 中华医学杂志, 2023, 103(24): 1849-1854.
9.	Schneider LM, Worthley S, Nickenig G, et al. 1-year outcomes following transfemoral transseptal transcatheter mitral valve replacement: the highlife TSMVR feasibility study. JACC Cardiovasc Interv, 2023, 16(23): 2854-2865.
10.	Hausleiter J, Stocker TJ, Adamo M, et al. Mitral valve transcatheter edge-to-edge repair. EuroIntervention, 2023, 18(12): 957-976.
11.	Faza NN, Little SH. Role of 3-dimensional transesophageal echocardiography in guiding transcatheter mitral valve replacement. Echocardiography, 2020, 37(6): 945-953.
12.	Polizzi V, Pergolini A, Zampi G, et al. Transcatheter mitral valve replacement with Tendyne^TM device: overview of three-dimensional echocardiography monitoring. Kardiol Pol, 2021, 79(10): 1161-1162.
13.	Ranard LS, Lebehn M, Ng V, et al. Iatrogenic atrial septal defects after transseptal transcatheter mitral valve replacement with a balloon-expandable valve. JACC Cardiovasc Interv, 2023, 16(5): 621-623.

1. Dziadzko V, Dziadzko M, Medina‐Inojosa JR, et al. Causes and mechanisms of isolated mitral regurgitation in the community: clinical context and outcome. Eur Heart J, 2019, 40(27): 2194-2202.
2. Iung B, Delgado V, Rosenhek R, et al. Contemporary presentation and management of valvular heart disease: the EURobservational research programme valvular heart disease Ⅱ Survey. Circulation, 2019, 140(14): 1156-1169.
3. Iung B, Delgado V, Lazure P, et al. Educational needs and application of guidelines in the management of patients with mitral regur- gitation. A European mixed-methods study. Eur Heart J, 2018, 39(15): 1295-1303.
4. Mirabel M, Iung B, Baron G, et al. What are the characteristics of patients with severe, symptomatic, mitral regurgitation who are denied surgery?. Eur Heart J, 2007, 28(11): 1358-1365.
5. Gheorghe LL, Mobasseri S, Agricola E, et al. Imaging for native mitral valve surgical and transcatheter interventions. JACC Cardiovasc Imaging, 2021, 14(1): 112-127.
6. Urena M, Lurz P, Sorajja P, et al. Transcatheter mitral valve implantation for native valve disease. EuroIntervention, 2023, 19(9): 720-738.
7. Lange R, Piazza N. HighLife transcatheter mitral valve replacement. EuroIntervention, 2016, 12(Y): Y81-Y83.
8. 陈飞, 赵振刚, 姚怡君, 等. 经房间隔途径经导管二尖瓣置换术治疗严重二尖瓣反流的可行性和安全性. 中华医学杂志, 2023, 103(24): 1849-1854.
9. Schneider LM, Worthley S, Nickenig G, et al. 1-year outcomes following transfemoral transseptal transcatheter mitral valve replacement: the highlife TSMVR feasibility study. JACC Cardiovasc Interv, 2023, 16(23): 2854-2865.
10. Hausleiter J, Stocker TJ, Adamo M, et al. Mitral valve transcatheter edge-to-edge repair. EuroIntervention, 2023, 18(12): 957-976.
11. Faza NN, Little SH. Role of 3-dimensional transesophageal echocardiography in guiding transcatheter mitral valve replacement. Echocardiography, 2020, 37(6): 945-953.
12. Polizzi V, Pergolini A, Zampi G, et al. Transcatheter mitral valve replacement with Tendyne^TM device: overview of three-dimensional echocardiography monitoring. Kardiol Pol, 2021, 79(10): 1161-1162.
13. Ranard LS, Lebehn M, Ng V, et al. Iatrogenic atrial septal defects after transseptal transcatheter mitral valve replacement with a balloon-expandable valve. JACC Cardiovasc Interv, 2023, 16(5): 621-623.

West China Medical Journal

Echocardiography-guided transseptal mitral valve replacement: a case report

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