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European Journal of Echocardiography Advance Access published online on November 21, 2009
European Journal of Echocardiography, doi:10.1093/ejechocard/jep173
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2009. For permissions please email: journals.permissions@oxfordjournals.org

The routine use of live three-dimensional transesophageal echocardiography in mitral valve surgery: clinical experience

Jeng Wei, Ming C. Hsiung, Shen Kou Tsai*, Ching-Huei Ou, Chung-Yi Chang, Yi Cheng Chang, Kuo Chen Lee, Sung-How Sue and Yi-Pen Chou

Division of Cardiovascular Diseases, Cheng-Hsin General Hospital, No 45, Cheng Hsin St, Beitou, Taipei, Taiwan

Received 4 July 2009; accepted after revision 13 October 2009.

* Corresponding author. Tel: +886 11 886 2 282 64548, Fax: +886 11 886 2 282 67411, Email: ch9198{at}chgh.org.tw


  Abstract

Background: Perioperative monitoring of mitral valve (MV) anatomy, function, and pathology is essential for surgical management of different MV disease.

Aims: To overcome the several potential pitfalls of two-dimensional transesophageal echocardiography (2D TEE) and offline 3D TEE.

Methods: Live 3D TEE was used to assess 73 patients (44 men and 29 women) with Carpentier type II MV regurgitation undergoing MV surgery perioperatively.

Results: The isolated segment most frequently involved was A2/P2, but A1or P1 rarely was involved in an isolated lesion or combined lesions. The agreement between 3D TEE finding and surgery was 88% (64/73). In nine patients, the live 3D TEE images revealed more segments or scallops with prolapse than the surgeon noted intraoperatively.

Conclusions: Live 3D TEE allows more sensitivity and was feasible identification of prolapse or flail of individual segments of MV leaflets during surgery. We conclude that live 3D TEE should be regarded as an important adjunct to the standard 2D TEE examination in making decisions about MV surgery.

Keywords: Live 3D TEE; Mitral valve repair


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