Figure 11.

Intraprocedural imaging-based guidance of TMVR. Imaging-based guidance of TMVR with the Medtronic Intrepid system is shown here. (A,B) The bi-commissural and X-plane-to-LVOT views on TEE are used to guide advancement of the device delivery system into the left atrium. Valve positioning and deployment follow. (C,D) Post-procedural TEE shows a well-seated Intrepid TMVR device. (E) MDCT assessment shows the valve in the appropriate position with no LVOTO. A, anterior; M, medial; MDCT, multidetector computed tomography; L, lateral; LVOT, left ventricular outflow tract; LVOTO, left ventricular outflow tract obstruction; P, posterior; TEE, transesophageal echocardiography; TMVR, transcatheter mitral valve replacement.