Using 3D echocardiography, it is possible to observe the repaired valve en face from both atrial (Figure 36) and ventricular perspectives, documenting the eccentricity, if any, of the dual orifices created by the device. Moreover 3D color displays also provide good definition of the site(s) of any residual regurgitation (Figures 37).

TEE provides a method for early detection of many of the potential complications of clip placement including perforation of the atrial wall resulting in pericardial effusion, partial dehiscence of the clip after initial seating and leaflet or chordal tears caused by repeated attempts to grasp the leaflets.

Following reduction of mitral regurgitation, it is expected that the LV dimensions and volumes will be reduced. Although the timing of LV remodeling in this setting is unclear, a 6-month assessment with TTE is reasonable.

Representative images from transthoracic studies performed after successful MitraClip™ placement are shown in Figure 38.