Ischemic Mitral Regurgitation: A Quantitative Three-Dimensional Echocardiographic Analysis

Vergnat, Mathieu; Jassar, Arminder S.; Jackson, Benjamin M.; Ryan, Liam; Eperjesi, Thomas J.; Pouch, Alison M.; Weiss, Stuart J.; Cheung, Albert T.; Acker, Michael A.; Gorman, Joseph H.; Gorman, Robert C.

doi:10.1016/j.athoracsur.2010.09.078

Cited by 65 publications

(53 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Specifically, the anterior annular points are defined as points on the anterior leaflet cm-rep boundary mapped to medial manifold edges that are not contained within the convex hull of the posterior leaflet. The anterior and posterior commissures are identified as points on the annular curve where the anterior and posterior leaflets meet, a definition that is consistent with the protocol described by Jassar et al 9 and Vergnat et al 8 An alternative definition of the commissures is described by Carpentier et al, 46 wherein several millimeters of valve tissue separates the free edge of the commissures from the annulus. Sometimes the commissures exist as separate leaflet segments, but more often the area is a subtle structure.…”

Section: Iid Feature Extractionmentioning

confidence: 93%

“…Sometimes the commissures exist as separate leaflet segments, but more often the area is a subtle structure. Given that commissures and=or commissural leaflets are difficult to define when the valve is closed, the commissural definition of Jassar et al 9 and Vergnat et al 8 is used in this work.…”

Section: Iid Feature Extractionmentioning

confidence: 99%

“…5,8,46 Annular dimensions indicate the presence of annular dilatation and identify whether an individual's annulus is predominantly saddle-shaped or planar. Leaflet tenting features are indicative of subvalvular remodeling.…”

Section: Iid Feature Extractionmentioning

confidence: 99%

See 2 more Smart Citations

Development of a semi-automated method for mitral valve modeling with medial axis representation using 3D ultrasound

Pouch¹,

Yushkevich²,

Jackson³

et al. 2012

Med. Phys.

Self Cite

View full text Add to dashboard Cite

Purpose: Precise 3D modeling of the mitral valve has the potential to improve our understanding of valve morphology, particularly in the setting of mitral regurgitation (MR). Toward this goal, the authors have developed a user-initialized algorithm for reconstructing valve geometry from transesophageal 3D ultrasound (3D US) image data. Methods: Semi-automated image analysis was performed on transesophageal 3D US images obtained from 14 subjects with MR ranging from trace to severe. Image analysis of the mitral valve at midsystole had two stages: user-initialized segmentation and 3D deformable modeling with continuous medial representation (cm-rep). Semi-automated segmentation began with useridentification of valve location in 2D projection images generated from 3D US data. The mitral leaflets were then automatically segmented in 3D using the level set method. Second, a bileaflet deformable medial model was fitted to the binary valve segmentation by Bayesian optimization. The resulting cm-rep provided a visual reconstruction of the mitral valve, from which localized measurements of valve morphology were automatically derived. The features extracted from the fitted cm-rep included annular area, annular circumference, annular height, intercommissural width, septolateral length, total tenting volume, and percent anterior tenting volume. These measurements were compared to those obtained by expert manual tracing. Regurgitant orifice area (ROA) measurements were compared to qualitative assessments of MR severity. The accuracy of valve shape representation with cm-rep was evaluated in terms of the Dice overlap between the fitted cm-rep and its target segmentation. Results: The morphological features and anatomic ROA derived from semi-automated image analysis were consistent with manual tracing of 3D US image data and with qualitative assessments of MR severity made on clinical radiology. The fitted cm-reps accurately captured valve shape and demonstrated patient-specific differences in valve morphology among subjects with varying degrees of MR severity. Minimal variation in the Dice overlap and morphological measurements was observed when different cm-rep templates were used to initialize model fitting. Conclusions: This study demonstrates the use of deformable medial modeling for semi-automated 3D reconstruction of mitral valve geometry using transesophageal 3D US. The proposed algorithm provides a parametric geometrical representation of the mitral leaflets, which can be used to evaluate valve morphology in clinical ultrasound images.

show abstract

Section: Iid Feature Extractionmentioning

confidence: 93%

Section: Iid Feature Extractionmentioning

confidence: 99%

See 1 more Smart Citation

Development of a semi-automated method for mitral valve modeling with medial axis representation using 3D ultrasound

Pouch¹,

Yushkevich²,

Jackson³

et al. 2012

Med. Phys.

Self Cite

View full text Add to dashboard Cite

show abstract

“…In functional MR, however, due to either global or regional LV systolic dysfunction the annulus remains relatively flat with reduced apical decent. 43,62 This pattern of annular dysfunction mirrors the basic categorization of MR as either primary, also known as organic MR (leaflet dysfunction, and annular enlargement with preserved dynamic function) or functional MR (grossly normal leaflets, and annular enlargement with loss of dynamic function).…”

Section: Surgical Annuloplastymentioning

confidence: 99%

Emerging Trends in Heart Valve Engineering: Part III. Novel Technologies for Mitral Valve Repair and Replacement

et al. 2014

View full text Add to dashboard Cite

Abstract-In this portion of an extensive review of heart valve engineering, we focus on the current and emerging technologies and techniques to repair or replace the mitral valve. We begin with a discussion of the currently available mechanical and bioprosthetic mitral valves followed by the rationale and limitations of current surgical mitral annuloplasty methods; a discussion of the technique of neo-chordae fabrication and implantation; a review the procedures and clinical results for catheter-based mitral leaflet repair; a highlight of the motivation for and limitations of catheterbased annular reduction therapies; and introduce the early generation devices for catheter-based mitral valve replacement.

show abstract

“…As such, a greater focus must be placed on optimizing methods to understand and improve the durability of repair. A multipronged approach to this would include such factors as (1) ring type selection (flexible versus rigid, partial versus complete ring), but more importantly, (2) identification of patients in whom annuloplasty alone may not address all the extra-annular geometric factors contributing to IMR in the first place (eg, papillary muscle displacement 16 as well as both anterior 17 and posterior 18 leaflet tethering).…”

Section: Article See P 2639mentioning

confidence: 99%

Functional, Ischemic Mitral Regurgitation

2012

View full text Add to dashboard Cite

Ischemic Mitral Regurgitation: A Quantitative Three-Dimensional Echocardiographic Analysis

Cited by 65 publications

References 22 publications

Development of a semi-automated method for mitral valve modeling with medial axis representation using 3D ultrasound

Development of a semi-automated method for mitral valve modeling with medial axis representation using 3D ultrasound

Emerging Trends in Heart Valve Engineering: Part III. Novel Technologies for Mitral Valve Repair and Replacement

Functional, Ischemic Mitral Regurgitation

Contact Info

Product

Resources

About