Study Summary Conclusions
Gogoladze G et al. 77 Prospective study, 10 normal;10 with 2 to 4+ FMR. 3D TEE; data analyzed using QLAB quantification software (Philips), which was able to accurately align orthogonal views from full volume 3D images. MV leaflet coaptation length is asymmetric in normal valves, with anterior dominance. The ”anterior leaflet reserve” compensates for the posterior movement of the coaptation line until the reserve is exceeded.
Cobey F C et al, 73 Prospective study, 25 patients with FMR underwent cardiac operations. 3D TEE, TomTec Imaging Systems at end-systolic 3D models (3D end-systolic MV coaptation zone/3D MV area) was used to produce a dimension less coaptation zone index that could then be used to compare individual valves. When indexed to the MV area, the 3D MV coaptation region is closely related to FMR severity. Assessment of the mitral coaptation may be a potentially powerful tool for perioperative evaluation of the MV competency.
Bouma W et al.80 Prospective study, 50 patients with IMR. 3D TEE; data analyzed using TomTec Imaging Systems at mid systole. Preoperative regional leaflet tethering of segment P3 is a strong independent predictor of IMR recurrence after undersized ring annuloplasty. For patients with a preoperative P3 tethering angle ≥29.9°, chordal-sparing valve replacement should be considered rather than valve repair.
Dan Wei et al.7 Prospective study, 20 patients underwent MV valvuloplasty for mitral regurgitation were included. 2D TEE; the coaptation height was defined as the length between the free edge of the anterior and posterior leaflets to left atrial surface level at end-systole. The MV repair with MV ring can cause morphological changes of the MV structure. The increase of coaptation height after MV repair may be one of the main factors regulating mitral regurgitation.
Cho E J et al. 75 Prospective study, 47 patients with chronic severe MR and preserved LV systolic function scheduled for MV repair were prospectively enrolled. 3D TEE was performed before the operation and immediately post-operative. Measurements taken using Philips Q-lab MV quantification software during late systole. MA height may be a useful prognostic factor for determining the timing of surgery in patients with chronic primary MR. Annulus height/BSA assessed by 3D TEE may provide additional information to predict LA remodeling after successful MV repair.
Feroze Mahmood et al. 74 Prospective study, IMR group, n=66; control group, n =10. 3D TEE; measurements taken using TomTec Imaging Systems at mid-systolic 3D models. Specific 3D variations in MV geometry can be used to reliably identify a significantly remodeled valve apparatus.
Bretschneider C et al. 76 Prospective study, 48 patients with chronic MI. The Magnetic Resonance Imaging (MRI) protocol included cine steady-state free-precession sequences in a 4-chamber view, 2-chamber view as well as in short-axis views from MV to apex. MR images were assessed by two independent experienced readers for the presence, extent and location of PM infarction. The presence of PM infarction does not correlate with IMR. The severity of mitral regurgitation is not increased in patients with partial or no PM infarction.