fig5

Figure 5. Three-dimensional printing-guided transcatheter edge-to-edge repair (TEER). (A) The three-dimensional reconstruction, physical 3D-printed model, and bench simulation are used to select and verify a safe transseptal puncture region away from the aneurysmal atrial septal artery. The red arrow indicates the planned puncture region; (B) Biplane TEE confirms tenting at the selected puncture site; (C) Three-dimensional TEE confirms the transseptal access location relative to the aneurysmal sac; (D) Biplane TEE shows successful leaflet capture and two MitraClip XTR devices at A2/P2 and A3/P3; (E) Color Doppler after clip deployment shows mild residual MR; (F and G) En face three-dimensional TEE views demonstrate the two clips and the final double-orifice mitral valve configuration. 3D: Three-dimensional; MR: mitral regurgitation; TEE: transesophageal echocardiography.