Welcome to our educational opportunity for the STS-ACC TVT Registry version 3.0 upgrade. In this learning activity, we will address data elements for MitraClip procedures with an emphasis on new and updated data elements. Please take note that MitraClip procedures will be referred to as capital TMV small r or capital TMV small rpr. Sequence 13737 Effective Regurgitant Orifice Area or EROA replaces Effective Orifice Area or EOA sequence 5698 from version 2.1. While EOA was only collected on pre-procedure status in version 2.1, EROA is collected in the ECHO results for both pre- and post-procedure ECHOs. This data element is applicable to both MitraL Repair, the clip, and MitraL Replacement procedures. From version 2.1 to version 3.0, there is no change in the assessment methods from EOA to EROA. Please note that the PISA acronym has been removed for version 3.0 and the acronym has been spelled out for Proximal Isovelocity Surface Area. When coding the MitraLeaflet clip procedure indication, all the separate data elements in version 2.1 have been placed in one data element, sequence 13792. All that apply may still be selected from the list when coding sequence 13792 in version 3. A new selection for version 3.0 for clip indication is Refractory to Guideline Determined Optimal Medical Therapy. A reference for GDMT can be obtained in the new valve guidelines that were published in December of 2020. A link has been provided at the bottom of the slide for your convenience. We do suggest that you convert the link to a PDF for ease and review of the article. The second new selection for sequence 13792 is Severe Pulmonary Hypertension. When coding the MitraClip devices, begin by entering the device ID in sequence 13797. Then enter the location of the MitraClip device in sequence 13800, noting users now have an additional selection of Other when the leaflet attachment does not meet standard AP attachment positioning. Then the registry wants to know if the clip device was implanted successfully, sequence 13799. If the clip was implanted successfully, then users are prompted to enter the device serial number in sequence 13798. And if the clip had been deployed, released from the seriable guide, and then removed from the patient, sequence 13802, deployed then removed, would be coded as Yes. This is a new data element. However, if a clip is not successfully implanted and No is coded for sequence 13799, then the reason would be entered in sequence 13801. These reasons remain the same from version 2.1, but have now been placed in alphabetical order.

STS-ACC TVT Registry version 3.0

MitraClip procedures

Effective Regurgitant Orifice Area

Proximal Isovelocity Surface Area

MitraLeaflet clip procedure indication