1. Transcatheter Mitral Valve Repair Tips and tricks for access
Andreas Gruentzig
Cardiovascular Center
Emory University, Atlanta, GA.
Transcatheter Mitral Valve Repair
Tips and tricks for access
Peter C. Block M.D.
CRT
Mar 28, 1

2. 1: MitraClip requires curvature and positioning of the delivery catheter in the LA so that the MitraClip can be placed at right angles to each plane of the mitral leaflets.
2: Transseptal puncture should be made “high and posterior” in the atrial septum (allows adequate space for the delivery catheter and the MitraClip to remain well above the plane of the mitral valve during positioning within the LA).
3: Too low or anterior ---- not be enough space between the delivery catheter and the mitral valve plane to allow adequate capture of the edges of the mitral leaflets within Clip.

3. LAA LA
BMV
LAA RA MV
IVC

4. LAA LA
BMV
LAA RA MV
IVC

5. Transseptal Puncture for Percutaneous Mitral Valve Repair:
Posterior and superior aspect of Septum
Bicaval view: Height:
Short axis: Posterior
4chamber view: Distance
From Puncture to point
of coaptation 3.5 to 4 cm

6. TS puncture for Percutaneous Mitral Valve Repair Real time 3D TEE imaging

7. The MitraClip
Changing view of patient selection From prolapse to functional and possibly even ischemic MR