Mitral valve-in-valve with 4D intracardiac echocardiography: Procedural and imaging technique

Transcatheter mitral valve-in-valve (ViV) has emerged as a safe and effective therapeutic option for patients with a degenerated mitral bioprosthesis. As procedural techniques mature and operator experience improve, there is a push to adopt a minimalist approach of using conscious sedation instead of general anesthesia for faster recovery. The heavy reliance on fluoroscopy for ViV deployment makes feasible the use of intracardiac echocardiography (ICE) instead of transesophageal echocardiography for other procedural imaging requirements. We hereby use a case example to illustrate a step-by-step approach of using four-dimensional ICE to guide transcatheter mitral ViV under conscious sedation.

Automated summary

Transcatheter mitral valve-in-valve (ViV) is a safe and effective treatment option for patients with a degenerated mitral bioprosthesis. Using four-dimensional intracardiac echocardiography (ICE) to guide the procedure under conscious sedation is a viable alternative to transesophageal echocardiography for other imaging requirements.