Reference : Mitral valve annuloplasty and papillary muscle relocation oriented by 3-dimensional t...
Scientific journals : Article
Human health sciences : Radiology, nuclear medicine & imaging
Human health sciences : Cardiovascular & respiratory systems
Mitral valve annuloplasty and papillary muscle relocation oriented by 3-dimensional transesophageal echocardiography for severe functional mitral regurgitation.
Fattouch, Khalil [> >]
Murana, Giacomo [> >]
Castrovinci, Sebastiano [> >]
Mossuto, Claudia [> >]
Sampognaro, Roberta [> >]
Borruso, Maria Giuliana [> >]
Bertolino, Emanuela Clara [> >]
Caccamo, Giuseppa [> >]
Ruvolo, Giovanni [> >]
LANCELLOTTI, Patrizio mailto [Centre Hospitalier Universitaire de Liège - CHU > > Cardiologie >]
Journal of Thoracic and Cardiovascular Surgery
4 Suppl
Yes (verified by ORBi)
United States
[en] Aged ; Blood Vessel Prosthesis Implantation/adverse effects ; Echocardiography, Three-Dimensional ; Echocardiography, Transesophageal ; Humans ; Image Interpretation, Computer-Assisted ; Italy ; Middle Aged ; Mitral Valve/physiopathology/surgery/ultrastructure ; Mitral Valve Annuloplasty/adverse effects ; Mitral Valve Insufficiency/physiopathology/surgery/ultrasonography ; Papillary Muscles/physiopathology/surgery/ultrasonography ; Predictive Value of Tests ; Severity of Illness Index ; Treatment Outcome
[en] OBJECTIVE: The study of the mitral valve apparatus and its modifications during functional mitral regurgitation (FMR) is better revealed by 3-dimensional (3D) transesophageal echocardiography (TOE). To plan mitral valve repair by annuloplasty and papillary muscle (PPM) relocation, we proposed a valve repair procedure oriented by the new main features obtained by real-time 3D TOE reconstruction of the mitral valve apparatus. METHODS: Since January 2008, 25 patients with severe FMR before mitral valve repair were examined. Mean coaptation depth and mean tenting area were 1.3 +/- 0.2 cm and 3.2 +/- 0.5 cm(2), respectively. Intraoperative 2D and 3D TOE were performed, followed by a 3D offline reconstruction of the mitral valve apparatus. A schematic mitral valve apparatus model was obtained. A geometric model like a truncated cone was traced in according to the preoperative measurements. The size of the prosthetic ring was selected preoperatively according to the anterior leaflet surface. The expected truncated cone after annuloplasty was retraced. A conventional normal coaptation depth about 0.6 cm was used to detect the new position of the PPM tips. RESULTS: Offline reconstruction of the mitral valve apparatus and respective truncated cone were feasible in all patients. The expected position of the PPM tips desirable to reach a normal tenting area with a coaptation depth 0.6 cm or less was obtained in all patients. After surgery, all parameters were calculated and no statistically significant difference was found compared with the expected data. CONCLUSIONS: PPM relocation plus ring annuloplasty reduce mitral valve tenting and may improve mitral valve repair results for patients with severe FMR. This technique may be easily and precisely guided by preoperative offline 3D echocardiographic mitral valve reconstruction.
Copyright A(c) 2012 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

File(s) associated to this reference

Fulltext file(s):

Restricted access
FATTOUCH_JThoracCardiovascSurg_2012_143.pdfPublisher postprint679.2 kBRequest copy

Bookmark and Share SFX Query

All documents in ORBi are protected by a user license.