PMC9871344_01
Baseline intraprocedural TEE images. Midesophageal biplane imaging of a long-axis and bicommissural view without and with color Doppler (A, B), three-dimensional surgeon's view without and with color Doppler demonstrating severe regurgitation (C, D), systolic flow reversal in the right upper pulmonary vein (E), and elevated transvalvular inflow gradients (F). Anterior leaflet cleft ( ) and A2/A3 prolapse ( ) are shown in 2D (A) and three-dimensional (C) imaging.
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The peak and mean transvalvular gradients were 15 mm Hg and 5 mm Hg, respectively (Figure 1, panel A in Videos 1-4).
Post-TEER intraprocedural TEE images. Midesophageal biplane imaging of a long-axis and bicommissural view without and with color Doppler demonstrating bileaflet capture with reduction to mild-moderate regurgitation (A, B), three-dimensional surgeon's view demonstrating angulated device positioning (dashed arrows) with tissue bridge and color Doppler (C, D), right upper pulmonary vein subsequently with systolic dominant flow (E), and stable transvalvular inflow gradients following device release (F).
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The peak and mean transvalvular gradients remained stable from baseline at 14 and 5 mm Hg, respectively (Figure 2).