Use of 3 dimensional transesophageal echocardiography for percutaneous mitral valve replacement (valve in valve technique)

Percutaneous mitral valve replacement via valve in valve technique is an alternative therapy for patients with significant bio-prosthetic mitral valve dysfunction who are not candidates for redo-mitral valve surgery. 3-D transesophageal echocardiogram is essential for baseline evaluation of bio-prosthetic mitral valve function as well as procedural guidance during percutaneous mitral valve replacement procedure. With further advancements in percutaneous procedures for management of structural heart disease, the importance of high quality imaging cannot be over emphasized. In complex mitral valve disease, anatomy cannot be fully appreciated by only 2-D echocardiography. 3-D echocardiography is essential for comprehensive evaluation of mitral valve anatomy and describing relation of catheters and devices involved in percutaneous procedures to anatomic structures in three dimensional space. 3-D modes such as X-plane imaging, live 3D imaging, 3-D zoom and color 3-D provide incremental information compared to 2-D echo. In addition 3-D TEE especially real time 3-D echo is essential for intra-procedural guidance during catheter based interventional procedures like percutaneous mitral valve replacement.

This course is designed for cardiologists, cardiac surgeons, anesthesiologists, sonographers and other medical providers involved in percutaneous mitral valve replacement procedure. This course will give a comprehensive overview of baseline evaluation of bio-prosthetic mitral valve function.  This course will describe both 2-D and 3-D imaging necessary to help evaluate the etiology, mechanism and severity of bio-prosthetic valve dysfunction. This course will also describe step by step imaging involved in intra-procedural guidance of percutaneous mitral valve replacement utilizing valve in valve technique.