ISSN: 1885-5857 Impact factor 2023 7.2
Vol. 77. Num. 11.
Pages 919-925 (November 2024)

Original article
Superiority of 3D planimetry over pressure half-time method for the assessment of mitral valve area after percutaneous edge-to-edge mitral repair

Superioridad de la planimetría 3D sobre el tiempo de hemipresión para evaluar el área valvular mitral tras la reparación mitral percutánea de borde a borde

Miriam Estrada LedesmaaDiana Bastidas PlazaaEduardo Pozo OsinaldeaPedro Marcos-AlbercaaCarmen Olmos BlancoaPatricia Mahía CasadoaMaría LuacesaJosé Juan Gómez de DiegoaLuis Nombela-FrancoaPilar Jiménez-QuevedoaGabriela TiradoaLuis Collado YurritabAntonio Fernández-OrtizaJulián VillacastínaJosé Alberto de Agustína
Imagen extra
Rev Esp Cardiol. 2024;77:919-25
Abstract
Introduction and objectives

There is limited evidence to identify the most accurate method for measuring the mitral valve area (MVA) after percutaneous edge-to-edge mitral repair. Our objective was to evaluate the optimal method in this context and its correlation with the mean transmitral gradient.

Methods

A registry of patients undergoing percutaneous mitral repair was conducted, analyzing different methods of measuring MVA and their correlation with the mean gradient.

Results

We analyzed data from 167 patients. The mean age was 76±10.3 years, 54% were men, and 46% were women. Etiology was degenerative in 45%, functional in 39%, and mixed in 16%. Postclip MVA measurements were 1.89±0.60 cm2 using pressure half-time (PHT), 2.87±0.83 cm2 using 3D planimetry, and the mean gradient was 3±1.19mmHg. MVA using 3D planimetry showed a stronger correlation with the mean gradient (r=0.46, P<.001) than MVA obtained by PHT (r=0.19, P=.048). Interobserver agreement was also higher with 3D planimetry than with PHT (intraclass correlation coefficient of 0.90 vs 0.81 and variation coefficient of 9.6 vs 19.7%, respectively).

Conclusions

Our study demonstrates that the PHT method significantly underestimates MVA after clip implantation compared with direct measurement using transesophageal 3D planimetry. The latter method also correlates better with postimplantation gradients and has less interobserver variability. These results suggest that 3D planimetry is a more appropriate method for assessing postclip mitral stenosis.

Keywords

Percutaneous mitral valve repair
Mitral valve area
3D planimetry
Pressure half-time
Mean gradient

Identify yourself

Not yet a subscriber to the journal?

Purchase access to the article

By purchasing the article, the PDF of the same can be downloaded

Price: 19,34 €

Phone for incidents

Monday to Friday from 9am to 6pm (GMT+1) except for the months of July and August, which will be from 9am to 3pm

Calls from Spain 932 415 960
Calls from outside Spain +34 932 415 960
Copyright © 2024. Sociedad Española de Cardiología
Are you a healthcare professional authorized to prescribe or dispense medications?