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

Figure 8

Noncentral ValveClamp implantation and its effect in a patient with a P3 prolapse and flail. Left column: real-time 3D TEE TrueVue mode; middle and right column: ME-commissural view and ME-LAX view of X-plane imaging mode, respectively. (a) X-plane image (systolic frame) helped the operator to identify a proper site of puncture (arrow). (b) The process of leaflet capture using the clamp (orange dotted line). (c) 3D TEE (diastolic frame) demonstrating a large and a small MV orifice (arrowheads) and X-plane image (systolic frame) showing two trivial residual regurgitant jets after clamp release (asterisks).

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