Abstract 19024: Differences in Mitral Valve Marginal Chordae Tendineae Length in Patients with Functional and Degenerative Mitral Regurgitation Using 3D Transesophageal Echocardiography from the Transgastric Approach
Background: Patients with degenerative mitral valve disease (MVD) frequently have elongated chordae tendineae. In patients with functional mitral regurgitation (FMR), leaflet adaptation has been described as a compensatory mechanism, but it is not clear whether chordae tendineae are also elongated. In this study, we compared marginal chordal length in patients with FMR and MVD using 3D transesophageal echocardiography (3DTEE) data sets acquired from the transgastric approach.
Methods: We studied 20 patients with FMR, 20 with MVD and 15 normal subjects (NL) using 3DTEE full-volume datasets acquired from the transgastric approach. Using multiplanar reconstruction, optimal planes were extracted to measure the chords. Chordal length was measured from the papillary muscle tip to the leaflet margin, during the cardiac phase when the chord was maximally stretched. Left ventricular end-systolic and end-diastolic dimensions (LVDd and LVDs) were measured according to the guidelines.
Results: 153 chords in FMR, 147 in MVD and 120 in NL were measured. Chords in MVD were significantly longer compared to both FMR and NL (Table). No difference in chordal length was noted between the FMR group and the NL, despite larger left ventricular dimensions in FMR group. The chords originating from the posterior papillary muscle (PPM) were longer than those originating from the anterior papillary muscle (APM) in all groups.
Conclusions: Marginal chords in FMR patients retain normal length despite left ventricular enlargement. Further studies are needed to determine whether differences exist in chordal length in patients with different etiologies of FMR.
Author Disclosures: K. Obase: None. L. Weinert: None. K. Kesner: None. A. Barry: None. K. Addetia: None. J.D. Roberts: None. M.M. Minhaj: None. V. Mor-Avi: None. V. Jeevanandam: None. R.M. Lang: None.
- © 2014 by American Heart Association, Inc.