Document Type

Conference Proceeding

Publication Date


Publication Title

J Am Coll Cardiol


Background: Transesophageal echocardiography (TEE) is an essential tool in many structural heart procedures, such as transcatheter mitral valve edge-to-edge repair (TEER). Interventional procedural TEE requires a unique skill set. This study aims to evaluate the complexity of interventional structural heart TEE used to guide TEER compared with standard of care (SOC) TEE studies performed at a single center.

Methods: A retrospective case-control analysis was performed of 200 patients who underwent TEE in the Henry Ford Health System. One hundred cases of interventional TEE-guided TEER were compared with 100 controls of SOC TEE. Complexity was quantified by the total duration of the procedure, the total number of images, and the number of 3-dimensional clips captured. The mean, median, and SD were compared between these 2 groups. Wilcoxon rank sum tests were used to evaluate statistical significance.

Results: One hundred intraprocedural TEE studies to guide TEER and 100 SOC TEE studies were analyzed. The mean duration of TEE procedures, the number of images, and the number of 3-dimensional clips were all significantly higher in the TEER group (P < 0.0001) (Table 1).

Conclusion: Interventional TEE guidance for TEER is significantly more complex and more time-consuming than SOC TEE. This is the first large-scale study demonstrating objective differences between interventional and SOC TEE. This conclusion implicates the necessity of dedicated training programs for interventional imaging, in addition to the necessity of reviewing the current reimbursement codes to account for such a difference.

Categories: STRUCTURAL: Valvular Disease: Mitral





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