Department of Internal Medicine/Cardiology, BG Klinikum Unfallkrankenhaus Berlin;
Department of Internal Medicine/Cardiology, BG Klinikum Unfallkrankenhaus Berlin.
J Vis Exp. 2021 Oct 16(176). doi: 10.3791/62053.
Percutaneous transcatheter edge-to-edge reconstruction of the mitral valve is a safe and well-established therapy for severe symptomatic mitral regurgitation in patients with high surgical risk. Echocardiographic guidance in addition to fluoroscopy is the gold standard and should be performed using a standardized technique. This article lays out our reproducible step by step echocardiographic guide including views, measurements as well as highlighting possible difficulties that may arise during the procedure. This article provides detailed and chronological echocardiographic views for each step of the procedure, especially preferences between 2D and 3D imaging. If needed, pulse wave, continuous wave and color doppler measurements are described. Furthermore, as there are no official recommendations for the quantification of mitral regurgitation during the percutaneous edge-to-edge-repair procedure, advice is also included for echocardiographic quantification after grasping the mitral leaflets and after device deployment. In addition, the article deals with important echocardiographic views to prevent and deal with possible complications during the procedure. Echocardiographic guidance during transcatheter mitral valve repair is mandatory. A structured approach improves the collaboration between interventionist and imager and is indispensable for a safe and effective procedure.
经皮二尖瓣瓣环成形术是一种安全且成熟的治疗方法，适用于手术风险高的重度有症状二尖瓣反流患者。除了透视外，超声心动图引导仍然是金标准，并且应该使用标准化技术进行。本文介绍了我们可重复的、一步一步的超声心动图指南，包括视图、测量以及在手术过程中可能出现的困难的要点。本文提供了每个手术步骤的详细和按时间顺序排列的超声心动图视图，特别是 2D 和 3D 成像之间的偏好。如果需要，还描述了脉冲波、连续波和彩色多普勒测量。此外，由于在经皮边缘到边缘修复过程中没有关于二尖瓣反流定量的官方建议，因此在抓取二尖瓣叶和器械部署后，也提供了关于超声心动图定量的建议。此外，本文还介绍了在手术过程中预防和处理可能出现的并发症的重要超声心动图视图。经皮二尖瓣修复术中的超声心动图引导是强制性的。结构化的方法可以提高介入医师和成像医师之间的协作，对于安全有效的手术是不可或缺的。
