RESUMO
OBJECTIVE: Percutaneous mitral repair is rapidly developing as an alternative to cardiac surgery in select patients. The Evalve percutaneous E2E system uses the MitraClip to replicate the surgical suture-based approach. This procedure requires real-time echocardiographic guidance in a unique and significant collaboration between echocardiographer and interventionalist. transesophageal echocardiography (TEE) is used as the primary imaging modality to guide this procedure and is essential to its success. METHODS: In EVEREST I, the US multicenter phase I safety and feasibility trial, 47 patients with 3 or 4+ mitral regurgitation (MR) were enrolled. The trial involved a standardized echocardiographic imaging protocol with a standardized anatomic-based vocabulary, predetermined standard TEE views, preprocedural strategy meetings, and display of echocardiographic aids to optimize communication and procedural efficiency during placement of the clip. RESULTS: TEE guidance facilitated the creation of a double-orifice mitral valve in all 47 patients enrolled (100%), and 40 patients were discharged with 1 or more clips (85%). At discharge, successful placement of a clip and Assuntos
Procedimentos Cirúrgicos Cardíacos/instrumentação
, Ecocardiografia Doppler em Cores/métodos
, Ecocardiografia Transesofagiana/métodos
, Insuficiência da Valva Mitral/cirurgia
, Idoso
, Velocidade do Fluxo Sanguíneo/fisiologia
, Cateterismo Cardíaco
, Desenho de Equipamento
, Humanos
, Insuficiência da Valva Mitral/diagnóstico por imagem
, Insuficiência da Valva Mitral/fisiopatologia
, Índice de Gravidade de Doença
, Resultado do Tratamento