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Multiplane Two‐Dimensional versus Real Time Three‐Dimensional Transesophageal Echocardiography in Ischemic Mitral Regurgitation
Author(s) -
Fattouch Khalil,
Castrovinci Sebastiano,
Murana Giacomo,
Novo Giuseppina,
Caccamo Giuseppa,
Bertolino Emanuela C.,
Sampognaro Roberta,
Novo Salvatore,
Ruvolo Giovanni,
Lancellotti Patrizio
Publication year - 2011
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/j.1540-8175.2011.01528.x
Subject(s) - medicine , mitral valve , papillary muscle , mitral regurgitation , mitral annulus , cardiology , mitral valve repair , radiology , blood pressure , diastole
Objectives: Intraoperative three‐dimensional (3D) transesophageal echocardiography (TEE) has been suggested to be a valuable technique for the evaluation of the mechanisms of ischemic mitral regurgitation (IMR). Studies comparing multiplane two‐dimensional (2D) with 3D TEE reconstruction of the mitral valve using the new mitral valve quantification (MVQ) software are lacking. We undertook a prospective comparison between multiplane 2D and 3D TEE for the assessment of IMR. Methods: We evaluated echocardiographically 45 patients with IMR who underwent mitral valve surgery in our institution. 2D and 3D TEE examinations followed by a 3D offline assessment of the mitral valve apparatus were performed in all patients. Offline analysis of mitral valve apparatus was conducted with QLAB–MVQ. Results: 3D TEE image acquisitions were performed in a short period of time and were feasible in all patients. Real time 3D TEE imaging was superior to 2D in identifying specific mitral scallops (A1, A3, P1, P3) and commissures. When compared with 2D TEE, 3D offline reconstruction of the mitral valve allows an accurate quantification of the shape and diameters of the mitral annulus. Both approaches provide almost similar values for the tenting area and the coaptation depth. The 3D approach gave the advantage of direct calculation of the leaflets angles, tenting volume, and surface of the leaflets. The interpapillary muscles distance at the level of the papillary muscle head was greater in 2D than in 3D. Conclusions: 3D TEE imaging provides valuable and complementary information to multiplane 2D TEE for the assessment of patients with IMR. (Echocardiography 2011;28:1125‐1132)