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