Echocardiographic Guidance of Transcatheter Mitral Valve Edge-To-Edge Repair

Transcatheter edge-to-edge mitral valve repair is an established, minimally invasive treatment option for selected patients with moderate-to-severe or severe mitral regurgitation. Although transcatheter edge-to-edge mitral valve repair offers a significant step forward in the management of mitral regurgitation, the rate of procedural-related complications is not trivial. Optimal peri-procedural imaging using transesophageal echocardiography is thus critical to determine procedural candidacy and ensure safe implantation. In this review of echocardiographic guidance of transcatheter mitral valve edge-to-edge repair, we present a step by step approach of the recommended echocardiographic views for evaluation of transcatheter edge-to-edge mitral valve repair before, during, and post-procedure including the guidance of septal puncture.