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You are here: Contents > 2017 > Volume 26 Number 5 September 2017 > MITRAL VALVE DISEASE > Intraoperative Transesophageal Echocardiography for Surgical Repair of Degenerative Mitral Regurgitation

Intraoperative Transesophageal Echocardiography for Surgical Repair of Degenerative Mitral Regurgitation

Calogera Pisano1,2, Claudia Calia1, Alessandro Ricasoli1, Oreste Fabio Triolo1, Vincenzo Argano1

1Unit of Cardiac Surgery, Department of Surgery and Oncology, University Hospital ‘P. Giaccone’, Palermo, Italy
2Electronic correspondence: bacalipi@libero.it

Background and aim of the study: Segmental analysis of diseased mitral valves is important to predict a successful surgical valve repair. An assessment was made of the comparative accuracy of intraoperative three-dimensional (3D) and two-dimensional (2D) transesophageal echocardiography (TEE) in the evaluation of mitral valve lesions when compared with intraoperative surgical segmental analysis.

Methods: A total of 42 consecutive patients (12 females, 30 males; mean age 70.5 ± 14 years) with severe mitral valve regurgitation due to degenerative disease and who underwent mitral valve repair was enrolled in the study. Complete 2D- and 3D-TEE were performed before surgery. The findings obtained using the different echocardiographic techniques were compared with intraoperative segmental analysis performed by a single operator who was blinded to the 2D- and 3D-TEE findings until the end of the inspection. The sensitivity and specificity of echocardiographic evaluations

 

of involved scallops were compared with surgical inspection.

Results: 3D-TEE allowed an accurate identification of all mitral lesions. Thirty-three patients had simple lesions at 3D-TEE and underwent a simple surgical procedure, while nine patients had complex lesions; in these latter cases complex surgical procedures were performed. 3D-TEE showed more sensitivity than 2D-TEE in the analysis of the anterior leaflet (A), in particular for A3 lesion (100% versus 25%, p <0.001) and for complex lesion (100% versus 33.3%, p <0.009).

Conclusion: 3D-TEE allowed a more accurate identification of mitral valve lesions compared with 2D-TEE. The greatest accuracy was achieved for analysis of the anterior leaflet. 3D-TEE should be regarded as an important adjunct to standard 2D-TEE in decisions regarding mitral valve repair.

The Journal of Heart Valve Disease 2017;26:547-556


Intraoperative Transesophageal Echocardiography for Surgical Repair of Degenerative Mitral Regurgitation

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