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Review
. 2023 May;23(5):189-195.
doi: 10.1016/j.bjae.2023.01.004. Epub 2023 Feb 24.

Anaesthesia for transcatheter mitral valve repair

A Dryden  1 , M Hynes  1 , B Hibbert  1
Affiliations
Review

Anaesthesia for transcatheter mitral valve repair

A Dryden et al. BJA Educ. 2023 May.
No abstract available

Keywords: anaesthesia; cardiac catheters; cardiac procedures; mitral valve insufficiency.

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Conflict of interest statement

The authors declare that they have no conflicts of interest.

Figures

Figure 1
Fig 1
Currently approved devices for transcatheter edge-to-edge mitral valve repair. (A) MitraClip G4 device by Abbot. (B) PASCAL device by Edwards Lifesciences. Images used with permission.
Figure 2
Fig 2
Transoesophageal echocardiographic imaging during transcatheter mitral valve repair. (A) Ideal position for puncture of the atrial septum in the mid-oesophageal bicaval view (Video 1). (B) Ideal position for puncture of the atrial septum in the on mid-oesophageal aortic valve short axis view (Video 2). (C) In the mid-oesophageal four-chamber view, the puncture site should be 4–4.5 cm above the mitral annulus. (D) Insertion of the delivery system and dilator into the left atrium. It is important to carefully monitor the position of the distal tip of the device to prevent perforation of the left atrial wall (Video 3). (E) Mid-oesophageal commissural and long axis views with X-plane imaging showing the clip and delivery system positioned above the mitral valve. Orthogonal imaging helps confirm correct positioning of the device (Video 4). (F) Three-dimensional (3D) imaging of the mitral valve from the left atrial aspect showing the clip positioned above the valve and oriented perpendicular to the line of coaptation (Video 5). (G) Mid-oesophageal commissural and long-axis views with X-plane imaging showing the clip attached to the leaflets in a closed position (Videos 6 and 7). (H) Three-dimensional imaging of the mitral valve from the left atrial aspect of a repaired mitral valve (Video 8). (I) Mid-oesophageal bicaval view with colour Doppler imaging showing a small iatrogenic atrial septal defect with left-to-right flow (Video 9). If reading the pdf online, please click on the respective panels to view the videos.
See this image and copyright information in PMC

References

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