Abstract 3372: Post-operative Assessment of Mitral Valve Repair with 3D Echocardiography is Superior to 2D Assessment
Introduction: Post-operative imaging of mitral valve repair is vital to document operative success. 2D echocardiography is limited in the detection of all mitral segments. We hypothesized that 3D echocardiography would provide superior imaging of repaired mitral valves, compared to 2D.
Methods: 25 consecutive mitral valve repairs were imaged by transthoracic 2D and 3D echocardiography using an iE33 machine (Philips Ultrasound, Bothell, USA), 3 months post-operation. Carpentier 8-segment score was derived for each mitral repair, accounting for surgical segment resection. Correct identification of the repaired segment, compared to the surgical gold standard, and the location and severity of residual mitral regurgitation were also noted.
Results: Adequate recognition of segments was more frequently obtained by 3D imaging (see Figure⇓) (95 % of segments by 3D c.f. 71% by 2D; p=0.0004). The major difference was seen at the commissures (47/50 commissures identified by 3D c.f. 31/50 by 2D; p=0.0005). There was close inter-observer agreement in the segment scores from 3D data sets (difference in segment score between observers was 3%; p=NS). Site of repair was correctly identified in 86.7% with 3D, compared to 66.7% with 2D (p=0.04). Non-hemodynamically significant residual regurgitation was noted in 4 patients. The origin of the jet was clearly visualized by 3D but not by 2D.
Conclusion: 3D transthoracic echocardiography is superior to 2D not only for the complete visualization of the mitral valve, in particular the commissures, but also for the detailed description of the mitral repair.