# Transcatheter Mitral Valve Intervention: Current and Future Role of Multimodality Imaging for Device Selection and Periprocedural Guidance

## TL;DR

This paper reviews the role of imaging in guiding transcatheter mitral valve interventions for treating mitral regurgitation.

## Contribution

It provides a comprehensive overview of imaging parameters for device selection and procedural guidance in TMVI.

## Key findings

- Multimodal imaging is essential for evaluating patient anatomy and selecting appropriate TMVI devices.
- Collaboration between imagers and interventionalists is crucial for procedural success.
- The paper outlines future directions for structural cardiovascular imaging in TMVI.

## Abstract

Mitral regurgitation (MR) is a broadly diffuse valvular heart disease (VHD) with a significant impact on the healthcare system and patient prognosis. Transcatheter mitral valve interventions (TMVI) are now well-established techniques included in the therapeutic armamentarium for managing patients with mitral regurgitation, either primary or functional MR. Even if the guidelines give indications regarding the correct management of this VHD, the wide heterogeneity of patients’ clinical backgrounds and valvular and heart anatomies make each patient a unique case, in which the appropriate device’s selection requires a multimodal imaging evaluation and a multidisciplinary discussion. Proper pre-procedural evaluation plays a pivotal role in judging the feasibility of TMVI, while a cooperative work between imagers and interventionalist is also crucial for procedural success. This manuscript aims to provide an exhaustive overview of the main parameters that need to be evaluated for appropriate device selection, pre-procedural planning, intra-procedural guidance and post-operative assessment in the setting of TMVI. In addition, it tries to give some insights about future perspectives for structural cardiovascular imaging.