Multimodality Imaging in Transcatheter Mitral Interventions

Both echocardiography (specifically transesophageal echocardiography [TEE]) and multidetector row computed tomography (MDCT) have played an integral role in preprocedural planning for transcatheter aortic valve replacement, heavily influencing the moniker of “multimodality imaging.” The strengths of each modalities are complementary (Table), although there is overlap between the preprocedural analyses which can be performed. Having 2 modalities capable of accurately measuring the same anatomic structure has clinical utility. For instance, mandated MDCT annular measurements could not be performed accurately by the core laboratory in 6% to 8% of patients in the Placement of Aortic Transcatheter Valves II SAPIEN 3 trial and thus required 3-dimensional (3D)-TEE for transcatheter valve sizing.