Intraoperative Transesophageal Echocardiography for Surgical Repair of Degenerative Mitral Regurgitation
| Autor: | Calogera, Pisano, Claudia, Calia, Alessandro, Ricasoli, Oreste, Fabio Triolo, Vincenzo, Argano |
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| Rok vydání: | 2018 |
| Předmět: |
Aged
80 and over Male Comparative Effectiveness Research Intraoperative Care Mitral Valve Annuloplasty Echocardiography Three-Dimensional Mitral Valve Insufficiency Middle Aged Sensitivity and Specificity Dimensional Measurement Accuracy Outcome Assessment Health Care Humans Mitral Valve Female Echocardiography Transesophageal Aged |
| Zdroj: | The Journal of heart valve disease. 26(5) |
| ISSN: | 0966-8519 |
| Popis: | Segmental analysis of diseased mitral valves is important to predict a successful surgical valve repair. An assessment was made of the comparative accuracy of intraoperative three-dimensional (3D) and two-dimensional (2D) transesophageal echocardiography (TEE) in the evaluation of mitral valve lesions when compared with intraoperative surgical segmental analysis.A total of 42 consecutive patients (12 females, 30 males; mean age 70.5 ± 14 years) with severe mitral valve regurgitation due to degenerative disease and who underwent mitral valve repair was enrolled in the study. Complete 2D- and 3D-TEE were performed before surgery. The findings obtained using the different echocardiographic techniques were compared with intraoperative segmental analysis performed by a single operator who was blinded to the 2D- and 3D-TEE findings until the end of the inspection. The sensitivity and specificity of echocardiographic evaluations of involved scallops were compared with surgical inspection.3D-TEE allowed an accurate identification of all mitral lesions. Thirty-three patients had simple lesions at 3D-TEE and underwent a simple surgical procedure, while nine patients had complex lesions; in these latter cases complex surgical procedures were performed. 3D-TEE showed more sensitivity than 2D-TEE in the analysis of the anterior leaflet (A), in particular for A3 lesion (100% versus 25%, p0.001) and for complex lesion (100% versus 33.3%, p0.009).3D-TEE allowed a more accurate identification of mitral valve lesions compared with 2D-TEE. The greatest accuracy was achieved for analysis of the anterior leaflet. 3D-TEE should be regarded as an important adjunct to standard 2D-TEE in decisions regarding mitral valve repair. |
| Databáze: | OpenAIRE |
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