Abstract 10947: Geometric Changes of Mitral Valve Before and After Successful Mitral Valve Repair Surgery: A Quantitative Analysis Using Real-Time Three-dimensional Transoesophageal Echocardiography
Background: This study evaluates the 3D anatomy of MV undergoing mitral repair.
Methods: Thirty patients (16 men, 54±13.9) with severe MR (8 PL prolapse, 14 AL prolapse, and 8 BL prolapse) and 20 control (14 men, 58.8±7.4) were studied. All patients underwent MV repair. RT3D-TEE was performed before and immediate after surgery. Quantitative 3D anatomic analysis of the MV was performed offline using dedicated software.
Results: There were variations in the 3D geometry of the mitral annulus, leaflets, and subvalvular apparatus among MR and compared to control (Table). Quantitative analysis of RT3D-TEE images showed significant reduction in the exposed area of both the anterior and posterior leaflets, perimeter of annulus, anterior to posterior annulus diameter, and volume of leaflets prolapse and tent (Table). Prolapse volume was significantly decreased (0.5±0.6 to 0.003±+0.01mL, P<0.001). Multiple linear regression analysis, angle of AL (HR -0.44, p=0.019) and non-planar angle of leaflets (HR 0.47, p=0.013) predict post OP MV mean PG.
Conclusions: Successful MV repair is universally characterized by significant surgical modification of the MV anatomy that results in prolapse elimination and subannular coaptation. RT3D-TEE provides new insights that allow the refining of mitral pathophysiology concepts.
- © 2011 by American Heart Association, Inc.