Real-Time Monitoring and Step-by-Step Guidance for Transapical Mitral Valve Edge-to-Edge Repair Using Transesophageal Echocardiography

Figure 6

3D CFD TEE assessment Patient A: (a) 3D TEE image with CFD showing a prolapse P2 segment (arrowheads) with a single wide central jet and (b) after implantation of 1 clamp, trivial residual mitral regurgitation is visible. Patient B: (c), (e), (f) in a case of noncentral bileaflet prolapse, prerelease 3D CFD TEE (d): early systolic frame, E: mid systolic frame) revealed a significant lateral residual MR following a central implantation of 1 clamp (c: white dotted line); after adjustment of position and regrasping of leaflets (c: green dotted line), two trivial residual MR jets are visible (f). This case highlighted the importance of precise clamp deployment for the maximal reduction of MR. Asterisks indicate clamps.

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