Mitral Annulus morphologic and functional analysis using real time tridimensional echocardiography in patients submitted to unsupported mitral valve repair

Guedes, Marco Antonio Vieira; Pomerantzeff, Pablo Maria Alberto; Brandão, Carlos Manuel de Almeida; Vieira, Marcelo Luiz Campos; Tarasoutchi, Flávio; Spinola, Pablo da Cunha; Jatene, Fábio Biscegli

doi:10.5935/1678-9741.20140082

Cited by 2 publications

(1 citation statement)

References 23 publications

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“…The rings fix the mitral annulus and prevent its contraction. Three-dimensional analysis shows that the mitral valve plane is saddle shaped [ 30 ] and has a dynamic behavior. At the end of the ventricular systole, the surface of the mitral valve orifice is reduced by up to 30% of its area, a phenomenon that contributes to valve competence.…”

Section: Discussionmentioning

confidence: 99%

Valvuloplasty Without Prosthetic Ring or Band in Patients with Degenerative Mitral Regurgitation: Long-Term Results and Predictive Factors for Outcomes

Kalil¹,

Belli²,

Mattos³

et al. 2021

Braz J Cardiovasc Surg

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Introduction Mitral valvuloplasty including ring/band support is widely performed despite potential drawbacks of rings. Unsupported valvuloplasty is performed in only a few centers. This study aimed to report long-term outcomes of patients undergoing unsupported valvuloplasty for degenerative mitral regurgitation (MR) and to identify predictive factors for outcomes. Methods This is a retrospective cohort including patients undergoing mitral valve repair for degenerative MR from 2000 to 2018. The main techniques were Wooler annuloplasty and quadrangular resection. Kaplan-Meier curves and Cox regression models were used for statistical analysis. Results One hundred fifty-eight patients were included (median age: 64.0 years). In-hospital mortality was 2.5%. Maximum follow-up was 19.6 years, with a median of 4.7 years (992 patient-years). Overall survival at 5, 10, and 15 years was 91.0% (95% confidence interval [CI]: 85.7-96.3), 87.6% (95% CI: 80.7-94.5), and 78.1% (95% CI: 65.9-90.3), respectively. The European System for Cardiac Operative Risk Evaluation (EuroSCORE) II was an independent predictor of late death (hazard ratio [HR] 1.42; P =0.016). Freedom from mitral reoperation at 5, 10, and 15 years was 88.1% (95% CI: 82.0-94.2), 82.4% (95% CI: 74.6-90.2), and 75.7% (95% CI: 64.1-87.3), respectively. Left atrial diameter > 56 mm was associated with late reintervention in univariate analysis (HR 1.06; P =0.049). Conclusion Degenerative MR can be successfully treated with repair techniques without annular support, thus avoiding the technical and logistical drawbacks of ring/band implantation while maintaining good long-term results. EuroSCORE II was a risk factor for late death, and larger left atrium was associated with late reoperation.

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Section: Discussionmentioning

confidence: 99%

Valvuloplasty Without Prosthetic Ring or Band in Patients with Degenerative Mitral Regurgitation: Long-Term Results and Predictive Factors for Outcomes

Kalil¹,

Belli²,

Mattos³

et al. 2021

Braz J Cardiovasc Surg

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Accuracy of mitral valve annulus measurements by two-and three-dimensional transesophageal echocardiography, compared to intraoperative measurements in patients undergoing mitral valve replacement surgery

Toufan Tabrizi,

Javanshir,

Khezerlouy-Aghdam

2024

J Res Clin Med

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Introduction: Transthoracic echocardiography (TTE) is the most beneficial diagnostic modality for mitral valve (MV) diseases. However, it is not accurate enough for MV annular sizing. Recent evidence has demonstrated the superiority of transesophageal echocardiography (TEE) over TTE. The present study aimed to evaluate the accuracy of two-dimensional TEE (2D-TEE) and three-dimensional TEE (3D-TEE) in preoperative measuring of MV size and specifications. Methods: This cross-sectional study evaluated patients with mitral valve replacement (MVR) surgery at Shahid Madani Heart Center of Tabriz university of Medical Sciences, Tabriz, Iran, in 2020. Thirty-eight patients admitted for MVR surgery were enrolled in this study. Demographic, electrocardiogram (ECG), and echocardiographic studies -including TTE, 2D, and 3D TEE- were performed preoperative for each patient. The accurate size and the specifications of the studied structure were measured by a surgical gauge caliper during the surgery, which was considered the gold standard value. The correlations between obtained parameters were evaluated using Pearson’s correlation coefficient. The data obtained from individual were entered into the SPSS software. Significance was set at P<0.05. Results: The mean age of patients was 55.89±11.81 years, and 65.8% were male. Most patients (68.4%) had sinus rhythm. The strongest correlation with the gold standard was observed in mitral annulus circumference measured by the three-dimensional multiplanar reconstruction (3D MPR) method in all patients (r=0.758, P<0.001), [(r=0.723, P<0.001) for patients with sinus rhythm, and (r=0.825, P=0.001) for patients with atrial fibrillation (AF)]. The minor difference between the echocardiographic measurements and the surgical rule was related to the short axis (SA) in the 3D MPR method (3.3 mm). Conclusion: This study illustrated a high correlation between 3D-MPR TEE measured MV annulus and intra-operative measurements using a surgical gauge caliper as the gold standard.

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Mitral Annulus morphologic and functional analysis using real time tridimensional echocardiography in patients submitted to unsupported mitral valve repair

Cited by 2 publications

References 23 publications

Valvuloplasty Without Prosthetic Ring or Band in Patients with Degenerative Mitral Regurgitation: Long-Term Results and Predictive Factors for Outcomes

Valvuloplasty Without Prosthetic Ring or Band in Patients with Degenerative Mitral Regurgitation: Long-Term Results and Predictive Factors for Outcomes

Accuracy of mitral valve annulus measurements by two-and three-dimensional transesophageal echocardiography, compared to intraoperative measurements in patients undergoing mitral valve replacement surgery

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