Introduction
Transcatheter mitral valve repair (TMVr) with the Mitraclip (Abbott, Minneapolis, MN) has extended the population of patients eligible for mitral valve therapy, yet there is a sizable portion of patients that are not candidates based on anatomical exclusions. [1],[2],[3]. While multiple societal guidelines recommend the use of transthoracic echocardiography (TTE) for the initial identification of etiology and severity of degenerative mitral regurgitation (MR), preoperative transesophageal echocardiography (TEE) is required for anatomic screening. [4]. TEE is used to obtain information including etiology of MR, scallop location of flail/prolapse, location and severity of regurgitant jet(s), and leaflet thickening/calcification. However, TEE is a semi-invasive diagnostic test that requires esophageal intubation and anesthesia. Multi-detector computed tomographic angiography (MDCT) provides high-resolution images and three-dimensional (3D) reconstructions that allow for a comprehensive assessment of complex mitral anatomy [5]. We hypothesized that MDCT can yield similar information to 3D TEE relevant to TMVr, reducing the need for a preoperative TEE.