Imaging Guidance for Transcatheter Mitral Valve Intervention on Prosthetic Valves, Rings, and Annular Calcification.

Catheter-based interventions to improve mitral valve function are dependent on anatomic and functional information provided by noninvasive imaging to plan, perform, and evaluate each intervention. In this review we highlight the importance of imaging guidance for catheter-based interventions on prosthetic mitral valves, surgical rings, and native valve annular calcification. Both repair and replacement procedures are discussed. We review the general features common to this collection of procedures and discuss specific imaging issues and concerns for each procedure. Figures and intraprocedural videos emphasize central messages using case examples. • Computed tomography is an essential imaging modality for patient selection and procedural planning of catheter-based mitral valve interventions on a prosthetic valve or calcified native annulus. • Echocardiography and limited fluoroscopy are principal imaging tools for intraprocedural guidance. Echocardiography is well suited for acute postprocedure functional evaluation. • Accurate prediction of left ventricular outflow tract patency is a specific imaging challenge for these interventions. • Functional evaluation of residual mitral regurgitation and paravalvular regurgitation post procedure are important tasks for the echocardiographer. [ABSTRACT FROM AUTHOR]