Role of real-time three-dimensional epicardial echocardiography in a novel transcatheter treatment techniques of mitral regurgitation:an acute in vivo animal study
10.3760/cma.j.issn.1004-4477.2018.09.018
- VernacularTitle:经水囊心外膜实时三维超声心动图在猪经心尖二尖瓣钳夹术中的应用价值
- Author:
Zhenyi GE
1
;
Cuizhen PAN
;
Wenzhi PAN
;
Daxin ZHOU
;
Haiyan CHEN
;
Wei LI
;
Jing SHI
;
Xianhong SHU
;
Junbo GE
Author Information
1. 复旦大学附属中山医院心超室 上海市心血管病研究所 上海市影像医学研究所
- Keywords:
Echocardiography;
intraoperative epicedial;
Transcatheter mitral valve repair;
Mitral regurgitation
- From:
Chinese Journal of Ultrasonography
2018;27(9):817-822
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the usefulness of real-time three-dimensional intraoperative epicardial echocardiography ( RT-3D IEE) in the process of transapical mitral valve repair and a new device's efficacy in an animal model . Methods Acute mitral regurgitation ( MR) was induced in 18 anesthetized domestic pigs as MR group by cutting chordae supporting the segment of the leaflet ( A2 , n = 9 ; P2 , n = 8 ;P3 , n = 1) ,while 15 pigs received no cutting chordae were chosed as normal mitral valve ( NMV ) group . The ValveClamp procedures were then transapically performed either on the prolapsing segment ( MR group) or A2/ P2 segment ( NMV group ) respectively solely under 3D epicardial echocardiographic guidance . Epicardial echocardiography was obtained before and after transcatheter interventions . Thirty days later all pigs were humanely killed to verify the location of implanted devices . Results In normal group , the preoperative max and mean mitral valve pressure gradient was higher than postoperative those ( P < 0 .0001) ,and no significant difference was found in other echocardiographic parameters . In MR group , the preoperative echocardiography showed that cutting the leaflet chordae caused severe ( n = 15 ) or moderate( n = 3) MR ,while postoperative immediate echo observed overt MR area reduction( P < 0 .0001) with 8 cases to slight ,5 cases to mild and 1 case eliminated .Furthermore ,the mean postoperative and max mitral valve pressure gradient significantly increased both in two groups ( P < 0 .0001 ) ,whereas no complications or other structural changes were observed ( P > 0 .05) .The autopsy report demonstrated that all ValveClamp devices were precisely placed to clamp either the prolapsing segments (MR group) of mitral valve or A2/P2 segments (NMV group) ,respectively .Conclusions Real-time three-dimensional epicardial echocardiography can independently monitor the new transcatheter mitral repair technique-ValveClamp , facilitating the overall procedure . Transapical implantation of ValveClamp device under epicardial echocardiographic guidance is effective in reducing acutely induced mitral regurgitation .
