Surgical Echocardiography of the MV: Focus on 3D

2018 ◽  
Vol 23 (1) ◽  
pp. 26-36 ◽  
Author(s):  
Meena Bhatia ◽  
Priya Kumar ◽  
Susan M. Martinelli
Keyword(s):  
Mitral Valve ◽  
Transesophageal Echocardiography ◽  
Color Doppler ◽  
Complex Structure ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Multiple Forms ◽  
Surgical Interventions ◽  
3 Dimensional ◽  
Valvular Diseases

The mitral valve remains a complex structure where multiple forms of pathology can be seen. Mitral regurgitation continues to be one of the most common valvular diseases in the industrialized world. While intraoperative 2-dimensional transesophageal echocardiography has been commonplace for some time, 3-dimensional technology has emerged and has shown great benefit for diagnosis and guidance during mitral valve surgery. In the hands of a trained sonographer, high-quality real-time images can easily be obtained and correlate well with gross anatomical findings. The use of multiple angled views and color Doppler within 3-dimensional transesophageal echocardiography has become a valuable asset in the understanding and interpretation of the mitral valve for surgical interventions.

scholarly journals Mitral annulus disjunction is associated with adverse outcome in Marfan and Loeys–Dietz syndromes

2020 ◽  
Author(s):  
Monica Chivulescu ◽  
Kirsten Krohg-Sørensen ◽  
Esther Scheirlynck ◽  
Beate R Lindberg ◽  
Lars A Dejgaard ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Surgery ◽  
Severe Disease ◽  
Mitral Annulus ◽  
Ventricular Myocardium ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Prognostic Information ◽  
Surgical Interventions ◽  
Younger Age

Abstract Aims We aimed to assess the prevalence of mitral annulus disjunction (MAD) and to explore the association with aortic disease and mitral valve surgery in patients with Marfan syndrome (MFS) and Loeys–Dietz syndrome (LDS). Methods and results We included consecutive MFS patients fulfilling Revised Ghent Criteria and LDS patients fulfilling Loeys–Dietz Revised Nosology. MAD was identified by echocardiography and was quantified as the longitudinal distance from the ventricular myocardium to the hinge point of the posterior mitral leaflet. Aortic events were defined as aortic dissection or prophylactic aortic surgery. We recorded the need of mitral valve surgery including mitral valve repair or replacement. We included 168 patients (103 with MFS and 65 with LDS). The prevalence of MAD was 41%. MAD was present in all age groups. Aortic events occurred in 112 (67%) patients (27 with dissections and 85 with prophylactic surgical interventions). Patients with MAD were younger at aortic event than those without MAD (log rank = 0.02) Patients with aortic events had greater MAD distance in posterolateral wall [8 (7–10) mm vs. 7 (6–8) mm, P = 0.04]. Mitral events occurred more frequently in patients with MAD (P < 0.001). Conclusion MAD was highly prevalent in patients with MFS and LDS. MAD was a marker of severe disease including aortic events at younger age and need of mitral valve surgery. Screening patients with MFS an LDS for MAD may provide prognostic information and may be relevant in planning surgical intervention. Detection of MAD in patients with MFS and LDS may infer closer clinical follow-up from younger age.

scholarly journals Redo mitral valve surgery

2018 ◽  
Vol 11 (1) ◽  
pp. 89
Author(s):  
Redoy Ranjan ◽  
Mushfiqur Rahman ◽  
Heemel Saha ◽  
Dipannita Adhikary ◽  
Sanjoy Kumar Saha ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Color Doppler ◽  
Systolic Pressure ◽  
Mechanical Valve ◽  
Mitral Valve Surgery ◽  
Valve Surgery ◽  
Pulmonary Artery Systolic Pressure ◽  
Female Ratio

<p class="Abstract">This study is based on the findings of a single surgeon’s practice of mitral valve replacement of 167 patients from April 2005 to June 2017 who developed symptomatic mitral restenosis after closed or open mitral commisurotomy. Both clinical and color doppler echocardiographic data of peri-operative and six months follow-up period were evaluated and compared to assess the early outcome of the redo mitral valve surgery. With male-female ratio of 1: 2.2 and after a duration of 6 to 22 years symptom free interval between the redo procedures, the selected patients with mitral valve restenosis undergone valve replacement with either mechanical valve in 62% cases and also tissue valve in 38% cases. Particular emphasis was given to separate the adhered pericardium from the heart completely to ameliorate base to apex and global contraction of the heart. Besides favorable post-operative clinical outcome, the echocardiographic findings were also encouraging as there was statistically significant increase in the mitral valve area and ejection fraction with significant decrease in the left atrial diameter, pressure gradient across the mitral valve and pulmonary artery systolic pressure. Therefore, in case of inevitable mitral restenosis after closed or open commisurotomy, mitral valve replacement is a promising treatment modality.</p>

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