Echo- Stress during Edge-to-Edge Mitral Valve Repair Can Be Useful

Transcatheter edge-to-edge mitral valve repair with Mitraclip has become a valid strategy to treat mitral valve regurgitation (MR) when surgery is not viable. However, after discharge, residual MR (>moderate) can affect over 10% of patients, because of the use of anesthesia, which alters pre and post procedural measurements. In this context, eco-stress could become a useful tool to identify patients presenting residual MR.

El eco-stress durante el tratamiento borde a borde puede ser útil

The study included 39 patients with severe MR undergoing edge-to-edge with MitraClip. After procedure, patients were tested with eco-stress with dobutamine under general anesthesia.

Mean age was 76, 39% were men, 36% hypertensive, 26% diabetic, 21% had prior MI, 23% PCI, 15% CABG, 54% atrial fibrillation, most were in functional class II-IV and most had high NT ProBNP.

Most patients received one or two clips.

By the end of procedure, 30 patients presented mild and moderate mitral valve regurgitation. 

After eco-stress with dobutamine, 11 patients saw increased MR. 6 presented >moderate.MR.

Read also: EuroPCR 2023 | ACURATE Neo2: Results After 5 Years.

Test diagnostic performance was established at 100% sensitivity and 85% specificity in unselected patients. 


The use of eco-stress during edge-to-edge can predict increased MR. In addition, it could support decision making during procedure, even when considering additional clips, and potentially improve evolution. 

Dr. Carlos Fava - Consejo Editorial SOLACI

Dr. Carlos Fava.
Member of the Editorial Board of

Original Title: Dobutamine stress echocardiography during transcatheter edge‐to‐edge mitral valve repair predicts residual mitral regurgitation.

Reference: Frank Meijerink, et al. Catheter Cardiovasc Interv. 2023;101:1128–1133.

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