Methods
Patients who underwent TMVr or were evaluated for transcatheter mitral
valve replacement (TMVR) for degenerative MR were retrospectively
analyzed from 2017 to 2019 at a single center (n= 87). Patients were
included in the analysis if preoperative MDCT was performed (n=22).
(Figure 1) Clinical information was collected from the patient chart and
surgical reports. This study was approved by the institutional board
review at Northwell Health. Two experienced TEE (board certified and
with more than 5 years’ experience) and two MDCT readers (board
certified and with less than 2 years’ experience), blinded to patient
outcomes and alternative imaging modality, analyzed the following
characteristics: leaflet pathology (flail, degenerative, mixed), leaflet
location (A1-3/P1-3), mitral valve area (MVA), flail width/gap,
anterior-posterior (AP) and commissural diameters, posterior leaflet
length, maximal leaflet thickness (measured at A2/P2 region), presence
of mitral valve cleft and degree of mitral annular calcification (MAC).
Figure 1 : Flowchart illustrating patient inclusion and
exclusion algorithm