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.