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Melillo et al. Mini-invasive Surg 2020;4:81 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2020.83

Review Open Access

Multimodality imaging for preprocedural planning of
percutaneous mitral valve repair: a comprehensive

review

Francesco Melillo , Antonio Boccellino , Giacomo Ingallina , Francesco Ancona , Cristina Capogrosso ,
1
1
1
1
1
Antonio Napolano , Stefano Stella , Eustachio Agricola 1,2
1
1
1 Cardiovascular Imaging Unit, San Raffaele Hospital, Milan 20132, Italy.
2 School of Medicine, Vita-Salute San Raffaele University, Milan 20132, Italy.
Correspondence to: Prof. Eustachio Agricola, Head of Cardiovascular Imaging Unit, Cardio-Thoracic-Vascular Department, San
Raffaele Hospital, Via Olgettina 60, Milan 20132, Italy. E-mail: agricola.eustachio@hsr.it
How to cite this article: Melillo F, Boccellino A, Ingallina G, Ancona F, Capogrosso C, Napolano A, Stella S, Agricola E. Multimodality
imaging for preprocedural planning of percutaneous mitral valve repair: a comprehensive review. Mini-invasive Surg 2020;4:81.
http://dx.doi.org/10.20517/2574-1225.2020.83
Received: 12 Aug 2020 First Decision: 18 Sep 2020 Revised: 28 Sep 2020 Accepted: 12 Oct 2020 Published: 6 Nov 2020

Academic Editor: Azeem Latib Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
New transcatheter mitral valve (MV) therapies are now available as alternatives to surgical and medical
treatments in patients at high or prohibitive operative risk. Multimodality imaging including echocardiography,
cardiac magnetic resonance, and cardiac computed tomography provide complementary information to guide
patient and device selection. Morphology and functional anatomy of the MV should be carefully evaluated to
determine the feasibility of percutaneous treatment; to identify the best therapeutic approach, either leaflet or
annulus or combined; and to predict the probability of procedural success that is crucial for subsequent outcome
and should be integrated by comprehensive preprocedural assessment of chamber size, biventricular systolic
and diastolic function, valvopathy hemodynamic impact and aortic or peripheral vascular disease. The spectrum
of transcatheter options is now wide and encompasses leaflet repair, direct or indirect annuloplasty, and cordal
implantation. The aim of this review is to provide an overview on the role of multimodality imaging in the patient
selection and preprocedural planning of percutaneous mitral valve repair.

Keywords: Transcatheter mitral intervention; 3D-echocardiography; multimodality imaging

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
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