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Relation of mitral valve morphology to surgical repair results in patients with mitral valve prolapse: A three‐dimensional transesophageal echocardiography study
Author(s) -
Pardi Mirian M.,
Pomerantzeff Pablo M. A.,
Sampaio Roney Orismar,
Abduch Maria C.,
Brandão Carlos M. A.,
Mathias Wilson,
Grinberg Max,
Tarasoutchi Flavio,
Vieira Marcelo L. C.
Publication year - 2018
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.14048
Subject(s) - medicine , papillary muscle , mitral valve prolapse , mitral regurgitation , cardiology , mitral valve repair , mitral valve , diastole , blood pressure
Background The identification of predictors of mitral valve ( MV ) repair results is important for quality improvement in cardiac surgery. The aim of this study was to evaluate the relationship between MV morphological quantification by three‐dimensional (3D) transesophageal echocardiography and mitral repair results. Methods Fifty‐four patients with MV prolapse who were submitted to surgical repair were divided into 2 groups according to their postoperative mitral regurgitation ( MR ) degree (group 1, grade 0‐I MR ; group 2, ≥grade II MR ). Morphological parameters related to the mitral ring, dimension of leaflets and prolapse, coaptation line, distance from papillary muscles to the leaflet border and valve angles were analyzed by 3D MV quantification. Cardiac remodeling and MR quantitative parameters were also evaluated. Results There was no correlation between 3D MV quantification and surgical results; a multivariate analysis did not show an association between morphological parameters and surgical outcome. The distance from the posteromedial papillary muscle to the leaflet border was higher ( P = .038) in patients with ≥grade II postoperative MR . The left atrial diameter, left ventricular end‐systolic diameter, left ventricular end‐diastolic and end‐systolic volumes were larger in patients with a significant residual MR ( P < .05). Conclusion Three‐dimensional MV quantification did not predict the postoperative MR grade; however, the distance from the posteromedial papillary muscles to the leaflet border may be related to suboptimal repair results. Furthermore, excessive cardiac remodeling was related to postoperative MR ≥ grade II , what could suggest a potential benefit of early surgical treatment.