key: cord-0758259-oai5ogrm
authors: Chen, Chunguang; Okoh, Alexis K.; Suhotliv, Amy; Erinne, Ikenna; Chaudhary, Ashok; Hakeem, Abdul; Sethi, Ankur; Salahuddin, Ayesha; Lee, Leonard Y.; Russo, Mark J.
title: Single Session Transesophageal Echocardiography and Transcatheter Mitral Valve Repair Using MitraClip in the COVID-19 Era
date: 2021-07-26
journal: JACC Cardiovasc Interv
DOI: 10.1016/j.jcin.2021.04.019
sha: 0f6af61dec814a3146a4ef0b6df28eb16482fa05
doc_id: 758259
cord_uid: oai5ogrm

nan

2.9 to 4.9 mm]; p ¼ 0.077). The other echocardiographic parameters were comparable in both groups.

The clip position was predominantly anteroseptal commissure in 84% of 4-leaflet TV and in 98% of 3leaflet TV. The rate of technical success (at leaflet 1 device implantation with no mortality or conversion to surgery) was numerically lower in 4-leaflet TV than in 3-leaflet TV (87% vs. 94%; p ¼ 0.19). In 3-leaflet TV, 5 failed procedures (6%) were caused by lack of optimal leaflet grasping (n ¼ 2) and device-related complications (n ¼ 3) including a leaflet perforation, an acute single leaflet detachment, and a device embolization. In 4-leaflet TV, 7 failed procedures (16%) were caused by lack of optimal leaflet grasping (n ¼ 3), chordae-related complications (n ¼ 3), and Chiari network (n ¼ 1). There was no intraprocedural death or emergency surgery in either configuration.

Overall, a procedural TR grade of moderate or less was similarly achieved in 89% (74 of 83 patients) of 3-leaflet TV and in 82% (37 of 45 patients) of 4-leaflet TV (p ¼ 0.29) ( Figure 1B) .

Procedural success was achieved in 72% of 3-leaflet TV and 78% of 4-leaflet TV, along with improvement of heart failure symptom. Kaplan-Meier analysis showed no significant differences in all-cause death ( Figure 1C) and a composite endpoint between both groups ( Figure 1D ). Letters J U L Y 2 6 , 2 0 2 1 : 1 6 1 6 - 

Consensus decision pathway on the management of mitral regurgitation

Comprehensive periprocedural transesophageal echocardiography is a key to success in transcatheter mitral repair

Expedited MitraCip: rapid evaluation, treatment, and discharge in the COVID-19 era

This retrospective study is part of a research protocol approved by Rutgers office of research regulatory affairs (Rutgers eCOI). All authors have reported that they have no relationships relevant to the contents of this paper to disclose. The authors attest they are in compliance with human studies committees and animal welfare regulations of the authors' institutions and Food and Drug Administration guidelines, including patient consent where appropriate. For more information, visit the Author Center.

We report our consecutive series of transcatheter mitral valve replacement (TMVR) cases performed using intracardiac echocardiography (ICE) guidance, in a minimalist approach using conscious sedation.