Skip to main content
Log in

Cardiac CT for Guiding Mitral Valve Interventions

  • Cardiac Computed Tomography (T Villines, Section Editor)
  • Published:
Current Cardiovascular Imaging Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The purpose of this paper is to review the current role of contrast-enhanced cardiac computed tomography (CT) in the peri-procedural planning of mitral valve (MV) repair.

Recent Findings

Cardiac CT is increasingly implemented in the peri-interventional management of patients undergoing MV repair or MV replacement due to its widespread availability and its ability to provide detailed information on the complex cardiac and valvular anatomy.

Summary

The complex anatomy of the MV challenges the management of minimally invasive MV repair with respect to device sizing and procedural planning. Advances in CT have enabled cardiac CT to provide critical information for the pre-procedural planning and post-procedural follow-up of MV repair. Therefore, it represents a key element in the improvement of the post-procedural outcome, the efficiency of implanted devices, and the prevention as well as advanced diagnostics of post-procedural complications. However, particular expertise is required to select adequate imaging protocols, perform comprehensive post-processing features, and to achieve specific quantitative image evaluation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Nkomo VT, Gardin JM, Skelton TN, Gottdiener JS, Scott CG, Enriquez-Sarano M. Burden of valvular heart diseases: a population-based study. Lancet. 2006;368(9540):1005–11. doi:10.1016/S0140-6736(06)69208-8.

    Article  PubMed  Google Scholar 

  2. Singh JP, Evans JC, Levy D, Larson MG, Freed LA, Fuller DL, et al. Prevalence and clinical determinants of mitral, tricuspid, and aortic regurgitation (the Framingham Heart Study). Am J Cardiol. 1999;83(6):897–902.

    Article  CAS  PubMed  Google Scholar 

  3. Bursi F, Enriquez-Sarano M, Nkomo VT, Jacobsen SJ, Weston SA, Meverden RA, et al. Heart failure and death after myocardial infarction in the community: the emerging role of mitral regurgitation. Circulation. 2005;111(3):295–301. doi:10.1161/01.CIR.0000151097.30779.04.

    Article  PubMed  Google Scholar 

  4. Yoshida K, Yoshikawa J, Shakudo M, Akasaka T, Jyo Y, Takao S, et al. Color Doppler evaluation of valvular regurgitation in normal subjects. Circulation. 1988;78(4):840–7.

    Article  CAS  PubMed  Google Scholar 

  5. Enriquez-Sarano M, Akins CW, Vahanian A. Mitral regurgitation. Lancet. 2009;373(9672):1382–94. doi:10.1016/S0140-6736 (09)60692-9.

    Article  PubMed  Google Scholar 

  6. Stewart MH, Jenkins JS. The evolving role of percutaneous mitral valve repair. Ochsner J. 2016;16(3):270–6.

    PubMed  PubMed Central  Google Scholar 

  7. Nishimura RA, Otto CM, Bonow RO, Carabello BA, Erwin JP 3rd, Fleisher LA, et al. 2017 AHA/ACC focused update of the 2014 AHA/ACC guideline for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2017; doi:10.1016/j.jacc.2017.03.011.

  8. American College of Cardiology/American Heart Association Task Force on Practice G, Society of Cardiovascular A, Society for Cardiovascular A, Interventions, Society of Thoracic S, Bonow RO, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circulation. 2006;114(5):e84–231. doi:10.1161/CIRCULATIONAHA.106.176857.

    Article  Google Scholar 

  9. Mehta RH, Eagle KA, Coombs LP, Peterson ED, Edwards FH, Pagani FD, et al. Influence of age on outcomes in patients undergoing mitral valve replacement. Ann Thorac Surg. 2002;74(5):1459–67.

    Article  PubMed  Google Scholar 

  10. Mirabel M, Iung B, Baron G, Messika-Zeitoun D, Detaint D, Vanoverschelde JL, et al. What are the characteristics of patients with severe, symptomatic, mitral regurgitation who are denied surgery? Eur Heart J. 2007;28(11):1358–65. doi:10.1093/eurheartj/ehm001.

    Article  PubMed  Google Scholar 

  11. Vahanian A, Alfieri O, Andreotti F, Antunes MJ, Baron-Esquivias G, Baumgartner H, et al. Guidelines on the Management of Valvular Heart Disease (version 2012): the Joint Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur J Cardiothorac Surg. 2012;42(4):S1–44. doi:10.1093/ejcts/ezs455.

    Article  PubMed  Google Scholar 

  12. • Feldman T, Kar S, Elmariah S, Smart SC, Trento A, Siegel RJ, et al. Randomized comparison of percutaneous repair and surgery for mitral regurgitation: 5-year results of EVEREST II. J Am Coll Cardiol. 2015;66(25):2844–54. doi:10.1016/j.jacc.2015.10.018. This paper delivers results of the 5-year clinical outcomes and durability of percutaneous mitral valve repair with the MitraClip ® system in comparison to surgical group in the EVEREST II study and showed that treatment strategy does not influence post-procedural survival.

    Article  PubMed  Google Scholar 

  13. Eggebrecht H, Schelle S, Puls M, Plicht B, von Bardeleben RS, Butter C, et al. Risk and outcomes of complications during and after MitraClip implantation: experience in 828 patients from the German TRAnscatheter mitral valve interventions (TRAMI) registry. Catheter Cardiovasc Interv. 2015;86(4):728–35. doi:10.1002/ccd.25838.

    Article  PubMed  Google Scholar 

  14. Maisano F, Taramasso M, Nickenig G, Hammerstingl C, Vahanian A, Messika-Zeitoun D, et al. Cardioband, a transcatheter surgical-like direct mitral valve annuloplasty system: early results of the feasibility trial. Eur Heart J. 2016;37(10):817–25. doi:10.1093/eurheartj/ehv603.

    Article  PubMed  Google Scholar 

  15. Abdelghani M, Spitzer E, Soliman OI, Beitzke D, Laggner R, Cavalcante R, et al. A simplified and reproducible method to size the mitral annulus: implications for transcatheter mitral valve replacement. Eur Heart J Cardiovasc Imaging. 2016; doi:10.1093/ehjci/jew132.

  16. • Theriault-Lauzier P, Mylotte D, Dorfmeister M, Spaziano M, Andalib A, Mamane S, et al. Quantitative multi-slice computed tomography assessment of the mitral valvular complex for transcatheter mitral valve interventions part 1: systematic measurement methodology and inter-observer variability. Euro Intervention. 2016;12(8):e1011–e20. doi:10.4244/EIJY15M11_09. This paper showed that CT-based pre-procedural mitral valve complex sizing is feasible and provides essential information that is important for patient selection and device sizing.

    PubMed  Google Scholar 

  17. Raman SV, Shah M, McCarthy B, Garcia A, Ferketich AK. Multi-detector row cardiac computed tomography accurately quantifies right and left ventricular size and function compared with cardiac magnetic resonance. Am Heart J. 2006;151(3):736–44. doi:10.1016/j.ahj.2005.04.029.

    Article  PubMed  Google Scholar 

  18. Weinreb JC, Larson PA, Woodard PK, Stanford W, Rubin GD, Stillman AE, et al. American College of Radiology clinical statement on noninvasive cardiac imaging. Radiology. 2005;235(3):723–7. doi:10.1148/radiol.2353050358.

    Article  PubMed  Google Scholar 

  19. Ohnesorge B, Flohr T, Becker C, Kopp AF, Schoepf UJ, Baum U, et al. Cardiac imaging by means of electrocardiographically gated multisection spiral CT: initial experience. Radiology. 2000;217(2):564–71. doi:10.1148/radiology.217.2.r00nv30564.

    Article  CAS  PubMed  Google Scholar 

  20. Alkadhi H, Bettex D, Wildermuth S, Baumert B, Plass A, Grunenfelder J, et al. Dynamic cine imaging of the mitral valve with 16-MDCT: a feasibility study. AJR Am J Roentgenol. 2005;185(3):636–46. doi:10.2214/ajr.185.3.01850636.

    Article  PubMed  Google Scholar 

  21. Alkadhi H, Desbiolles L, Stolzmann P, Leschka S, Scheffel H, Plass A, et al. Mitral annular shape, size, and motion in normals and in patients with cardiomyopathy: evaluation with computed tomography. Investig Radiol. 2009;44(4):218–25. doi:10.1097/RLI.0b013e3181994a73.

    Article  Google Scholar 

  22. Morris MF, Maleszewski JJ, Suri RM, Burkhart HM, Foley TA, Bonnichsen CR, et al. CT and MR imaging of the mitral valve: radiologic-pathologic correlation. Radiographics. 2010;30(6):1603–20. doi:10.1148/rg.306105518.

    Article  PubMed  Google Scholar 

  23. Chen JJ, Manning MA, Frazier AA, Jeudy J, White CS. CT angiography of the cardiac valves: normal, diseased, and postoperative appearances. Radiographics. 2009;29(5):1393–412. doi:10.1148/rg.295095002.

    Article  PubMed  Google Scholar 

  24. Levine RA, Handschumacher MD, Sanfilippo AJ, Hagege AA, Harrigan P, Marshall JE, et al. Three-dimensional echocardiographic reconstruction of the mitral valve, with implications for the diagnosis of mitral valve prolapse. Circulation. 1989;80(3):589–98.

    Article  CAS  PubMed  Google Scholar 

  25. • Silbiger JJ. Anatomy, mechanics, and pathophysiology of the mitral annulus. Am Heart J. 2012;164(2):163–76. doi:10.1016/j.ahj.2012.05.014. This paper gives an entire overview of the anatomy and pathophysiology of the mitral valve annulus, which is essential for the CT-based pre-procedural acquisition and measurement.

    Article  PubMed  Google Scholar 

  26. • McCarthy KP, Ring L, Rana BS. Anatomy of the mitral valve: understanding the mitral valve complex in mitral regurgitation. Eur J Echocardiogr. 2010;11(10):i3–9. doi:10.1093/ejechocard/jeq153. The authors of this paper provide essential information about the anatomy of the mitral valve.

    Article  PubMed  Google Scholar 

  27. Silbiger JJ, Bazaz R. Contemporary insights into the functional anatomy of the mitral valve. Am Heart J. 2009;158(6):887–95. doi:10.1016/j.ahj.2009.10.014.

    Article  PubMed  Google Scholar 

  28. Lam JH, Ranganathan N, Wigle ED, Silver MD. Morphology of the human mitral valve. I. Chordae tendineae: a new classification. Circulation. 1970;41(3):449–58.

    Article  CAS  PubMed  Google Scholar 

  29. • Feldman T, Kar S, Rinaldi M, Fail P, Hermiller J, Smalling R, et al. Percutaneous mitral repair with the MitraClip system: safety and midterm durability in the initial EVEREST (Endovascular Valve Edge-to-Edge REpair Study) cohort. J Am Coll Cardiol. 2009;54(8):686–94. doi:10.1016/j.jacc.2009.03.077. This paper of the EVEREST II prospective multicenter single-arm study presents first results of patients who underwent the MitraClip ® system intervention in comparison to conventional surgery and also provides essential information on mitral valve complex dimensions and measurements to prevent post-procedural complications.

    Article  PubMed  Google Scholar 

  30. • Wan B, Rahnavardi M, Tian DH, Phan K, Munkholm-Larsen S, Bannon PG, et al. A meta-analysis of MitraClip system versus surgery for treatment of severe mitral regurgitation. Ann Cardiothorac Surg. 2013;2(6):683–92. doi:10.3978/j.issn.2225-319X.2013.11.02. This meta-analysis including 435 paper analyzed efficacy, post-procedural outcome and safety of MitraClip ® system with conventional surgery in patients with severe mitral valve regurgitation and found no difference in clinical outcome for both groups.

    PubMed  PubMed Central  Google Scholar 

  31. Linde C, Gold MR, Abraham WT, St John Sutton M, Ghio S, Cerkvenik J, et al. Long-term impact of cardiac resynchronization therapy in mild heart failure: 5-year results from the REsynchronization reVErses Remodeling in Systolic left vEntricular dysfunction (REVERSE) study. Eur Heart J. 2013;34(33):2592–9. doi:10.1093/eurheartj/eht160.

    Article  PubMed  Google Scholar 

  32. Vakil K, Roukoz H, Sarraf M, Krishnan B, Reisman M, Levy WC, et al. Safety and efficacy of the MitraClip(R) system for severe mitral regurgitation: a systematic review. Catheter Cardiovasc Interv. 2014;84(1):129–36. doi:10.1002/ccd.25347.

    Article  PubMed  Google Scholar 

  33. Taramasso M, Maisano F, Latib A, Denti P, Buzzatti N, Cioni M, et al. Clinical outcomes of MitraClip for the treatment of functional mitral regurgitation. Euro Intervention. 2014;10(6):746–52. doi:10.4244/EIJV10I6A128.

    PubMed  Google Scholar 

  34. Muller DW, Farivar RS, Jansz P, Bae R, Walters D, Clarke A, et al. Transcatheter mitral valve replacement for patients with symptomatic mitral regurgitation: a global feasibility trial. J Am Coll Cardiol. 2017;69(4):381–91. doi:10.1016/j.jacc.2016.10.068.

    Article  PubMed  Google Scholar 

  35. Guerrero M, Dvir D, Himbert D, Urena M, Eleid M, Wang DD, et al. Transcatheter mitral valve replacement in native mitral valve disease with severe mitral annular calcification: results from the first multicenter global registry. JACC Cardiovasc Interv. 2016;9(13):1361–71. doi:10.1016/j.jcin.2016.04.022.

    Article  PubMed  Google Scholar 

  36. Ormiston JA, Shah PM, Tei C, Wong M. Size and motion of the mitral valve annulus in man. II. Abnormalities in mitral valve prolapse. Circulation. 1982;65(4):713–9.

    Article  CAS  PubMed  Google Scholar 

  37. Ormiston JA, Shah PM, Tei C, Wong M. Size and motion of the mitral valve annulus in man. I. A two-dimensional echocardiographic method and findings in normal subjects. Circulation. 1981;64(1):113–20.

    Article  CAS  PubMed  Google Scholar 

  38. Suri RM, Grewal J, Mankad S, Enriquez-Sarano M, Miller FA Jr, Schaff HV. Is the anterior intertrigonal distance increased in patients with mitral regurgitation due to leaflet prolapse? Ann Thorac Surg. 2009;88(4):1202–8. doi:10.1016/j.athoracsur.2009.04.112.

    Article  PubMed  Google Scholar 

  39. Carpentier AF, Pellerin M, Fuzellier JF, Relland JY. Extensive calcification of the mitral valve anulus: pathology and surgical management. J Thorac Cardiovasc Surg. 1996;111(4):718–29. discussion 29-30

    Article  CAS  PubMed  Google Scholar 

  40. Savage DD, Garrison RJ, Castelli WP, McNamara PM, Anderson SJ, Kannel WB, et al. Prevalence of submitral (anular) calcium and its correlates in a general population-based sample (the Framingham Study). Am J Cardiol. 1983;51(8):1375–8.

    Article  CAS  PubMed  Google Scholar 

  41. Kohsaka S, Jin Z, Rundek T, Boden-Albala B, Homma S, Sacco RL, et al. Impact of mitral annular calcification on cardiovascular events in a multiethnic community: the Northern Manhattan Study. JACC Cardiovasc Imaging. 2008;1(5):617–23. doi:10.1016/j.jcmg.2008.07.006.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Benjamin EJ, Plehn JF, D’Agostino RB, Belanger AJ, Comai K, Fuller DL, et al. Mitral annular calcification and the risk of stroke in an elderly cohort. N Engl J Med. 1992;327(6):374–9. doi:10.1056/NEJM199208063270602.

    Article  CAS  PubMed  Google Scholar 

  43. Chen X, Turley RS, Andersen ND, Desai BS, Glower DD. Minimally invasive edge-to-edge mitral repair with or without artificial chordae. Ann Thorac Surg. 2013;95(4):1347–53. doi:10.1016/j.athoracsur.2012.12.026.

    Article  PubMed  Google Scholar 

  44. Sundermann SH, Gordic S, Manka R, Cesarovic N, Falk V, Maisano F, et al. Computed tomography for planning and postoperative imaging of transvenous mitral annuloplasty: first experience in an animal model. Int J Cardiovasc Imaging. 2015;31(1):135–42. doi:10.1007/s10554-014-0516-7.

    Article  PubMed  Google Scholar 

  45. Nickenig G, Schueler R, Dager A, Martinez Clark P, Abizaid A, Siminiak T, et al. Treatment of chronic functional mitral valve regurgitation with a percutaneous annuloplasty system. J Am Coll Cardiol. 2016;67(25):2927–36. doi:10.1016/j.jacc.2016.03.591.

    Article  PubMed  Google Scholar 

  46. Cheung A, Webb JG, Barbanti M, Freeman M, Binder RK, Thompson C, et al. 5-year experience with transcatheter transapical mitral valve-in-valve implantation for bioprosthetic valve dysfunction. J Am Coll Cardiol. 2013;61(17):1759–66. doi:10.1016/j.jacc.2013.01.058.

    Article  PubMed  Google Scholar 

  47. Seiffert M, Conradi L, Baldus S, Schirmer J, Knap M, Blankenberg S, et al. Transcatheter mitral valve-in-valve implantation in patients with degenerated bioprostheses. JACC Cardiovasc Interv. 2012;5(3):341–9. doi:10.1016/j.jcin.2011.12.008.

    Article  PubMed  Google Scholar 

  48. Cullen MW, Cabalka AK, Alli OO, Pislaru SV, Sorajja P, Nkomo VT, et al. Transvenous, antegrade melody valve-in-valve implantation for bioprosthetic mitral and tricuspid valve dysfunction: a case series in children and adults. JACC Cardiovasc Interv. 2013;6(6):598–605. doi:10.1016/j.jcin.2013.02.010.

    Article  PubMed  Google Scholar 

  49. Altiok E, Koos R, Schroder J, Brehmer K, Hamada S, Becker M, et al. Comparison of two-dimensional and three-dimensional imaging techniques for measurement of aortic annulus diameters before transcatheter aortic valve implantation. Heart. 2011;97(19):1578–84. doi:10.1136/hrt.2011.223974.

    Article  PubMed  Google Scholar 

  50. Wuest W, Anders K, Schuhbaeck A, May MS, Gauss S, Marwan M, et al. Dual source multidetector CT-angiography before transcatheter aortic valve implantation (TAVI) using a high-pitch spiral acquisition mode. Eur Radiol. 2012;22(1):51–8. doi:10.1007/s00330-011-2233-0.

    Article  CAS  PubMed  Google Scholar 

  51. Hansson NC, Thuesen L, Hjortdal VE, Leipsic J, Andersen HR, Poulsen SH, et al. Three-dimensional multidetector computed tomography versus conventional 2-dimensional transesophageal echocardiography for annular sizing in transcatheter aortic valve replacement: influence on postprocedural paravalvular aortic regurgitation. Catheter Cardiovasc Interv. 2013;82(6):977–86. doi:10.1002/ccd.25005.

    Article  PubMed  Google Scholar 

  52. De Backer O, Piazza N, Banai S, Lutter G, Maisano F, Herrmann HC, et al. Percutaneous transcatheter mitral valve replacement: an overview of devices in preclinical and early clinical evaluation. Circ Cardiovasc Interv. 2014;7(3):400–9. doi:10.1161/CIRCINTERVENTIONS.114.001607.

    Article  PubMed  Google Scholar 

  53. Schoenhagen P, Numburi U, Halliburton SS, Aulbach P, von Roden M, Desai MY, et al. Three-dimensional imaging in the context of minimally invasive and transcatheter cardiovascular interventions using multi-detector computed tomography: from pre-operative planning to intra-operative guidance. Eur Heart J. 2010;31(22):2727–40. doi:10.1093/eurheartj/ehq302.

    Article  PubMed  Google Scholar 

  54. Jakobs TF, Becker CR, Ohnesorge B, Flohr T, Suess C, Schoepf UJ, et al. Multislice helical CT of the heart with retrospective ECG gating: reduction of radiation exposure by ECG-controlled tube current modulation. Eur Radiol. 2002;12(5):1081–6. doi:10.1007/s00330-001-1278-x.

    Article  PubMed  Google Scholar 

  55. Stolzmann P, Leschka S, Scheffel H, Krauss T, Desbiolles L, Plass A, et al. Dual-source CT in step-and-shoot mode: noninvasive coronary angiography with low radiation dose. Radiology. 2008;249(1):71–80. doi:10.1148/radiol.2483072032.

    Article  PubMed  Google Scholar 

  56. Neefjes LA, Dharampal AS, Rossi A, Nieman K, Weustink AC, Dijkshoorn ML, et al. Image quality and radiation exposure using different low-dose scan protocols in dual-source CT coronary angiography: randomized study. Radiology. 2011;261(3):779–86. doi:10.1148/radiol.11110606.

    Article  PubMed  Google Scholar 

  57. Rosu C, Bouchard D, Pellerin M, Lebon JS, Jeanmart H. Preoperative vascular imaging for predicting intraoperative modification of peripheral arterial cannulation during minimally invasive mitral valve surgery. Innovations (Phila). 2015;10(1):39–43. doi:10.1097/IMI.0000000000000112.

    Article  Google Scholar 

  58. Okuyama K, Jilaihawi H, Kashif M, Takahashi N, Chakravarty T, Pokhrel H, et al. Transfemoral access assessment for transcatheter aortic valve replacement: evidence-based application of computed tomography over invasive angiography. Circ Cardiovasc Imaging. 2015;8(1) doi:10.1161/CIRCIMAGING.114.001995.

  59. Delgado V, Kapadia S, Marsan NA, Schalij MJ, Tuzcu EM, Bax JJ. Multimodality imaging before, during, and after percutaneous mitral valve repair. Heart. 2011;97(20):1704–14. doi:10.1136/hrt.2011.227785.

    Article  PubMed  Google Scholar 

  60. Choure AJ, Garcia MJ, Hesse B, Sevensma M, Maly G, Greenberg NL, et al. In vivo analysis of the anatomical relationship of coronary sinus to mitral annulus and left circumflex coronary artery using cardiac multidetector computed tomography: implications for percutaneous coronary sinus mitral annuloplasty. J Am Coll Cardiol. 2006;48(10):1938–45. doi:10.1016/j.jacc.2006.07.043.

    Article  PubMed  Google Scholar 

  61. Eleid MF, Foley TA, Said SM, Pislaru SV, Rihal CS. Severe mitral annular calcification: multimodality imaging for therapeutic strategies and interventions. JACC Cardiovasc Imaging. 2016;9(11):1318–37. doi:10.1016/j.jcmg.2016.09.001.

    Article  PubMed  Google Scholar 

  62. Lancellotti P, Moura L, Pierard LA, Agricola E, Popescu BA, Tribouilloy C, et al. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: mitral and tricuspid regurgitation (native valve disease). Eur J Echocardiogr. 2010;11(4):307–32. doi:10.1093/ejechocard/jeq031.

    Article  PubMed  Google Scholar 

  63. Lancellotti P, Pibarot P, Chambers J, Edvardsen T, Delgado V, Dulgheru R, et al. Recommendations for the imaging assessment of prosthetic heart valves: a report from the European Association of Cardiovascular Imaging endorsed by the Chinese Society of Echocardiography, the Inter-American Society of Echocardiography, and the Brazilian Department of Cardiovascular Imaging. Eur Heart J Cardiovasc Imaging. 2016;17(6):589–90. doi:10.1093/ehjci/jew025.

    Article  PubMed  Google Scholar 

  64. Mangold S, Castillo-Sang M, Schoepf UJ, Leipsic JA, Fuller SR, Wichmann JL, et al. Imaging in minimally invasive mitral valve repair. J Thorac Imaging. 2015;30(6):378–85. doi:10.1097/RTI.0000000000000169.

    Article  PubMed  Google Scholar 

  65. Blanke P, Dvir D, Cheung A, Levine RA, Thompson C, Webb JG, et al. Mitral annular evaluation with CT in the context of transcatheter mitral valve replacement. JACC Cardiovasc Imaging. 2015;8(5):612–5. doi:10.1016/j.jcmg.2014.07.028.

    Article  PubMed  Google Scholar 

  66. • Blanke P, Dvir D, Cheung A, Ye J, Levine RA, Precious B, et al. A simplified D-shaped model of the mitral annulus to facilitate CT-based sizing before transcatheter mitral valve implantation. J Cardiovasc Comput Tomogr. 2014;8(6):459–67. doi:10.1016/j.jcct.2014.09.009. The authors of this study provide essential information about the assessment of the mitral valve by defining a simplified D-shaped mitral annular assessment for CT in comparison to the traditional saddle-shaped mitral annular assessment, yielding a significantly larger hypothetical LVOT clearance.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Flachskampf FA, Chandra S, Gaddipatti A, Levine RA, Weyman AE, Ameling W, et al. Analysis of shape and motion of the mitral annulus in subjects with and without cardiomyopathy by echocardiographic 3-dimensional reconstruction. J Am Soc Echocardiogr. 2000;13(4):277–87.

    Article  CAS  PubMed  Google Scholar 

  68. Kaye DM, Byrne M, Alferness C, Power J. Feasibility and short-term efficacy of percutaneous mitral annular reduction for the therapy of heart failure-induced mitral regurgitation. Circulation. 2003;108(15):1795–7. doi:10.1161/01.CIR.0000096051.23734.28.

    Article  PubMed  Google Scholar 

  69. Liddicoat JR, Mac Neill BD, Gillinov AM, Cohn WE, Chin CH, Prado AD, et al. Percutaneous mitral valve repair: a feasibility study in an ovine model of acute ischemic mitral regurgitation. Catheter Cardiovasc Interv. 2003;60(3):410–6. doi:10.1002/ccd.10662.

    Article  PubMed  Google Scholar 

  70. Kliger C, Jelnin V, Sharma S, Panagopoulos G, Einhorn BN, Kumar R, et al. CT angiography-fluoroscopy fusion imaging for percutaneous transapical access. JACC Cardiovasc Imaging. 2014;7(2):169–77. doi:10.1016/j.jcmg.2013.10.009.

    Article  PubMed  Google Scholar 

  71. Kumar R, Jelnin V, Kliger C, Ruiz CE. Percutaneous paravalvular leak closure. Cardiol Clin. 2013;31(3):431–40. doi:10.1016/j.ccl.2013.05.004.

    Article  PubMed  Google Scholar 

  72. Schoepf UJ, Zwerner PL, Savino G, Herzog C, Kerl JM, Costello P. Coronary CT angiography. Radiology. 2007;244(1):48–63. doi:10.1148/radiol.2441052145.

    Article  PubMed  Google Scholar 

  73. Alkadhi H, Wildermuth S, Bettex DA, Plass A, Baumert B, Leschka S, et al. Mitral regurgitation: quantification with 16-detector row CT—initial experience. Radiology. 2006;238(2):454–63. doi:10.1148/radiol.2381042216.

    Article  PubMed  Google Scholar 

  74. Feuchtner GM, Stolzmann P, Dichtl W, Schertler T, Bonatti J, Scheffel H, et al. Multislice computed tomography in infective endocarditis: comparison with transesophageal echocardiography and intraoperative findings. J Am Coll Cardiol. 2009;53(5):436–44. doi:10.1016/j.jacc.2008.01.077.

    Article  PubMed  Google Scholar 

  75. Habets J, Symersky P, van Herwerden LA, de Mol BA, Spijkerboer AM, Mali WP, et al. Prosthetic heart valve assessment with multidetector-row CT: imaging characteristics of 91 valves in 83 patients. Eur Radiol. 2011;21(7):1390–6. doi:10.1007/s00330-011-2068-8.

    Article  PubMed  PubMed Central  Google Scholar 

  76. de Heer LM, Habets J, Kluin J, Stella PR, Mali WP, van Herwerden LA, et al. Assessment of a transcatheter heart valve prosthesis with multidetector computed tomography: in vitro and in vivo imaging characteristics. Int J Cardiovasc Imaging. 2013;29(3):659–68. doi:10.1007/s10554-012-0111-8.

    Article  PubMed  Google Scholar 

  77. Mauri L, Foster E, Glower DD, Apruzzese P, Massaro JM, Herrmann HC, et al. 4-year results of a randomized controlled trial of percutaneous repair versus surgery for mitral regurgitation. J Am Coll Cardiol. 2013;62(4):317–28. doi:10.1016/j.jacc.2013.04.030.

    Article  PubMed  Google Scholar 

  78. Arnous S, Killeen RP, Martos R, Quinn M, McDonald K, Dodd JD. Quantification of mitral regurgitation on cardiac computed tomography: comparison with qualitative and quantitative echocardiographic parameters. J Comput Assist Tomogr. 2011;35(5):625–30. doi:10.1097/RCT.0b013e31822d28b8.

    Article  PubMed  Google Scholar 

  79. Suchá D, Chamuleau SA, Symersky P, Meijs MF, van den Brink RB, de Mol BA, et al. Baseline MDCT findings after prosthetic heart valve implantation provide important complementary information to echocardiography for follow-up purposes. Eur Radiol. 2016;26(4):997–1006. doi:10.1007/s00330-015-3918-6.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Fabian Bamberg.

Ethics declarations

Conflict of Interest

Fabian Bamberg reports grants and personal fees from Siemens Healthcare, grants and personal fees from Bayer Healthcare, and personal fees from Bracco, outside the submitted work. All other authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Cardiac Computed Tomography

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Storz, C., Mangold, S., Mueller, K.A. et al. Cardiac CT for Guiding Mitral Valve Interventions. Curr Cardiovasc Imaging Rep 10, 31 (2017). https://doi.org/10.1007/s12410-017-9428-y

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s12410-017-9428-y

Keywords

Navigation