Intraoperative Transesophageal Echocardiography for Evaluation of Mitral Valve Repair
Hiroshi Kawano MD, Teruaki Mizoguchi MD, Shigeaki Aoyagi MD

Intraoperative transesophageal echocardiography (TEE) is useful in assessing immediate operative results. However, incorrect assessment of the repaired valve sometimes leads to the need for reoperation. This study was performed to evaluate the accuracy of color Doppler in assessing the competence of repaired mitral valves. Both TEE and left ventriculography were performed, and results compared. The cut-off points to identify angiographic grades 1+, 2+ and 3+/4+ were 2, 4 and 7 cm², respectively. Using this relationship, post bypass intraoperative TEE was performed in 34 patients who underwent mitral valve repair to assess the competence of the repaired valve. On the basis of our results, it is important that mitral valve repair should be completed with a maximal mosaic area <2.0 cm², as assessed by intraoperative TEE, in order to reduce the need for reoperation.