Tools for Echocardiographic Calculations

Muhamed Saric, MD, PhD
New York University


Mitral Clip Screening

Exclusion Criteria

Below are the basic anatomic exclusion criteria for mitral valve clipping in addition to the following:

bulletA2 or P2 calcification in the grasping area or the presence of any significant cleft
bulletPrimary regurgitant jet NOT originating from malcoaptation of the A2 and P2
bulletSevere mitral annular calcifications
bulletMitral stenosis (mitral valve area < 4.0 cm2)
bulletLV end-systolic diameter > 5.5 cm
bulletLVEF < 25%
bulletPresence of ASD (whether repaired or not) or significant atrial septal aneurysm
bulletPresence of LA thrombus, vegetation or mass
bulletPresence of PFO associated with clinical symptoms

Degenerative Mitral Regurgitation

In the United States, mitral clip is approved for the use in degenerative mitral regurgitation. Approved indication:
bulletSignificant symptomatic degenerative mitral valve disease with mitral regurgitation ≥ 3+ in patients who have too high a risk for surgery.


Functional Mitral Regurgitation

In the United States, as of now, mitral clipping for functional mitral regurgitation is done within clinical trials such as the COAPT trial.