scholarly journals The Application of Transesophageal Echocardiography in Mitral Valve Repair With Tendon Reconstruction

2020 ◽  
Vol 7 ◽  
Author(s):  
Li Zhou ◽  
Ji-wei Gu ◽  
Yun Wang ◽  
Jing-jing Ye ◽  
Fang Wang ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Transesophageal Echocardiography ◽  
Mitral Valve Repair ◽  
Tendon Rupture ◽  
Short Axis ◽  
Short Axis View ◽  
Valve Repair ◽  
Tendon Reconstruction ◽  
Axis View

Objective: To investigate whether tendon reconstruction during mitral valve repair can be effectively guided by transesophageal echocardiography (TEE), using the mid-esophageal bi-commissure view, bicaval view and the aortic valve–mitral valve transition short-axis view.Methods: A total of 40 patients that underwent mitral valve repair with artificial tendineae were recruited. Before the operation, conventional transthoracic echocardiography was used to determine whether mitral valve repair would be possible. Following intraoperative anesthesia, two-dimensional and three-dimensional TEE reconstructions were used to assess the state of the valve and tendon and to make a repair plan.Results: TEE accurately diagnosed single functional tendon rupture and predicted single artificial tendon implantation in 88% of cases (23/26). TEE accurately diagnosed single functional tendon rupture and predicted the implantation of two artificial tendons in 100% of cases (4/4). TEE accurately diagnosed two or more functional tendon ruptures and predicted the implantation of two artificial tendons in 100% of cases (5/5). The length of the tendon cord predicted by TEE (2.45 ± 0.15 mm) was not significantly different (P > 0.05) from the length of the cord that was actually implanted (2.31 ± 0.11 mm). TEE also accurately predicted the size of the annuloplasty ring in 86% of cases (33/38), with differences of 2 mm or less compared to the size of the ring that was actually implanted.Conclusion: Both the mid-esophageal bi-commissure view, bicaval view and the short-axis view of the aortic valve–mitral valve transition can reduce the difficulty of tendon reconstruction by helping to determine what length of tendon and what size of artificial annulus are required.

ECHOCARDIOGRAPHY PREDICTORS OF SUCCESSFUL MITRAL VALVE REPAIR IN DEGENERATIVE MITRAL VALVE REGURGITATION

2015 ◽  
pp. 77-82
Author(s):  
Ba Minh Du Le ◽  
Anh Vu Nguyen ◽  
Duc Phu Bui
Keyword(s):  
Mitral Valve ◽  
Transesophageal Echocardiography ◽  
Success Rate ◽  
Mitral Valve Repair ◽  
Transthoracic Echocardiography ◽  
Mitral Valve Prolapse ◽  
Posterior Leaflet ◽  
Valve Repair ◽  
Mitral Repair ◽  
Fibroelastic Deficiency

Background and aim of the study: Mitral repair is now as the treatement of choice in patients suffering mitral regurgitation due to mitral valve prolapse or flail. However, mitral valve repair demands the mitral valve morphology being feasible for repair. The study aims at evaluating transthoracic and transesophageal echocardiographic features in consecutive patients with mitral valve prolapse or flail undergoing surgical repair at Hue Central Hospital. The correlation between preoperative and intraoperative echocardiographic features and surgical findings in these patients. These echocardiographic data may predict the surgical outcome. Methods: From December 2010 to January 2013, 73 patients (37 men, 36 women; average age 37.5) were recruited into the study. All patients had degenerative mitral valve disease causing important regurgitation and underwent systematic preoperative transthoracic echocardiography, preoperative and intraoperative transesophageal echocardiography for delineation of six segments (scallops) of anterior and posterior leaflets. Results: Among 73 patients, 64 patients were in fibroelastic deficiency (87.7%) and 9 patients suffered Barlow disease (12.3%). Mitral valve repair was performed in 52 patients (71.2%) and mitral replacement was performed in 21 patients (28.8%). All 52 mitral valve repair (81.3%) and 12 mitral valve replacement (18.7%) was performed in fibroelastic deficiency patients. All 9 Barlow patients must undergo mitral valve replacement (100%). A prolapse or flail of mitral valve in 73 patients was documented by transthoracic and transesophageal echocardiography and confirmed on surgical inspection. Accuracy of transthoracic echocardiography was (89.0%) and accuracy of transesophageal echocardiography was (91.8%) in identifying mitral valve segments prolapse or flail. Success rate of mitral valve repair was (98.0%) in prolapse of 1 or 2 segments, but was low (36.0%) in prolapse > 3 segments. Success rate of mitral valve repair was (96.6%) in prolapse of posterior leaflet, but was (63.6%) in prolapse anterior leaflet or bileaflet. Conclusion: - Mitral valve repair was favorable in fibroelastic deficiency patients, but difficult in Barlow patients. - Accuracy of transthoracic and transesophageal echocardiography was high in identifying mitral valve segments prolapse or flail. - Success rate of mitral valve repair was high in prolapse of 1 or 2 segments. - Success rate of mitral valve repair was high in in prolapse of posterior leaflet. Key words: Mitral repair, echocardiography, degenerative, Barlow, fibroelastic deficiency, prolapse, flail

Mitral Valve Repair Versus Replacement in Simultaneous Mitral and Aortic Valve Surgery for Rheumatic Disease

2007 ◽  
Vol 83 (2) ◽  
pp. 558-563 ◽  
Author(s):  
Kenji Kuwaki ◽  
Nobuyoshi Kawaharada ◽  
Kiyofumi Morishita ◽  
Tetsuya Koyanagi ◽  
Hisayoshi Osawa ◽  
...  
Keyword(s):  
Mitral Valve ◽  
Aortic Valve ◽  
Rheumatic Disease ◽  
Mitral Valve Repair ◽  
Valve Surgery ◽  
Aortic Valve Surgery ◽  
Valve Repair

Aortic valve regurgitation

2021 ◽  
pp. 181-190
Author(s):  
Julien Magne ◽  
Patrizio Lancellotti
Keyword(s):  
Aortic Valve ◽  
Transoesophageal Echocardiography ◽  
Correct Identification ◽  
Short Axis ◽  
Short Axis View ◽  
Valve Regurgitation ◽  
Chamber View ◽  
Imaging Tool ◽  
Line Imaging ◽  
Axis View

Transthoracic echocardiography (TTE) is the first-line imaging tool to assess aortic valve (AV), aorta, and subsequent aortic regurgitation (AR). The parasternal long-axis view is classically used to measure the left outflow tract, the aortic annulus, and the aortic sinuses. Leaflet thickening and morphology can be visualized from this window as well as from the parasternal short-axis view and the apical five-chamber view. Nevertheless, 2D TTE may be limited and not enabling correct identification of the anatomy and causes of AR. In this situation, 3D echocardiography and cardiac magnetic resonance (CMR) could provide better delineation of the AV morphology. In some cases, transoesophageal echocardiography (TOE) could be required, more particularly for assessing the aortic root dimensions.

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