Fig. 4

Exemplary 3D models of the acute effects of TMVR on the mitral valve of Low Responder (left) and High Responder (right). Upper picture: Overview of three-dimensional transesophageal echocardiography images comparing Low and High Responder before and after TMVR. Mitral regurgitation jet is visible (right arrow) as well as the MitraClip^® device (asterisk) itself. a 3D TEE image of Low Responder before TMVR showing severe MR. b 3D TEE image of Low Responder after TMVR showing mild MR. c 3D TEE image of High Responder before TMVR showing severe MR. d 3D TEE image of High Responder after TMVR showing mild MR. Lower picture: Left: 3D model of mitral valves (MV) before and after TMVR of Low Responders with corresponding colored models placed on top of each other to demonstrate change in annular size. Model of MV before and after clip with little change in annular size. Right: Model of Qlab MV before and after TMVR. Change in annular size is more prominent here. AML anterior mitral leaflet, AV aortic valve, C circumference, LA left atrium, LV left ventricle, MV mitral valve, MVA mitral valve annulus, PML posterior mitral leaflet, target indicates mitral regurgitation jet, asterisk indicates clip