RT Journal Article
T1 Three-dimensional color doppler transesophageal echocardiography for mitral paravalvular leak quantification and evaluation of percutaneous closure success
A1 Franco, Eduardo
A1 Almería, Carlos
A1 De Agustín Loeches, José Alberto
A1 Arreo del Val, Viviana
A1 Gómez de Diego, José Juan
A1 García Fernández, Miguel Ángel
A1 Macaya Miguel, Carlos
A1 Pérez De Isla, Leopoldo
A1 Garcia, Eulogio
AB Background: Three-dimensional (3D) color Doppler transesophageal echocardiography (TEE) enables accurate planimetry of the effective regurgitant orifice (ERO) of a mitral paravalvular leak (PVL). The aim of this study was to evaluate the usefulness of this method to quantify paravalvular regurgitation and to assess percutaneous PVL closure success, compared with 3D planimetry of PVLs without using color-flow images (3D anatomic regurgitant orifice [ARO]).Methods: Forty-six patients (59 mitral PVLs) who underwent 3D TEE to evaluate the indication of PVL closure procedure were retrospectively included. Receiver operating characteristic curves were compared to identify degree III and IV paravalvular regurgitation of 3D color ERO and 3D ARO measures. Forty patients underwent percutaneous PVL closure procedures; analysis was conducted to determine whether the undersizing of the closure devices according to 3D color ERO and 3D ARO measures was associated with PVL closure failure.Results: Three-dimensional ERO measures showed better areas under the curve than 3D ARO measures and correlated better with the degree of paravalvular regurgitation. Three-dimensional color ERO major diameter ≥ 0.65 cm showed a positive predictive value of 87.1% and a negative predictive value of 94% to diagnose degree III and IV paravalvular regurgitation. For the 40 patients who underwent PVL closure procedures, the immediate technical success rate was 76.9%, and 1-year estimated survival was 69.5%. Closure device undersizing according to 3D color ERO length, but not other PVL measurements, was significantly associated with PVL closure failure (P = .007).Conclusion: Three-dimensional ERO was superior to 3D ARO at identifying the presence of degree III and IV paravalvular regurgitation. The undersizing of closure devices according to 3D color ERO length was associated with failed closure procedures. Confirmatory prospective studies are encouraged.
PB Elsevier
SN 1097-6795
YR 2014
FD 2014
LK https://hdl.handle.net/20.500.14352/131357
UL https://hdl.handle.net/20.500.14352/131357
LA eng
NO Franco, E., Almería, C., de Agustín, J. A., Arreo Del Val, V., Gómez de Diego, J. J., García Fernández, M. Á., Macaya, C., Pérez de Isla, L., & Garcia, E. (2014). Three-dimensional color Doppler transesophageal echocardiography for mitral paravalvular leak quantification and evaluation of percutaneous closure success. Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography, 27(11), 1153–1163. https://doi.org/10.1016/j.echo.2014.08.019
DS Docta Complutense
RD 20 mar 2026