BACKGROUND AND AIM OF THE STUDY: Intraoperative real-time three-dimensional transesophageal echocardiography (RT-3D TEE) was used to examine the geometric changes that occur in the mitral annulus immediately after aortic valve replacement (AVR). METHODS: A total of 35 patients undergoing elective surgical AVR under cardiopulmonary bypass was enrolled in the study. Intraoperative RT-3D TEE was used prospectively to acquire volumetric echocardiographic datasets immediately before and after AVR. The 3D echocardiographic data were analyzed offline using TomTec Mitral Valve Assessment software to assess changes in specific mitral annular geometric parameters. RESULTS: Datasets were successfully acquired and analyzed for all patients. A significant reduction was noted in the mitral annular area (-16.3%, p < 0.001), circumference (-8.9%, p < 0.001) and the anteroposterior (-6.3%, p = 0.019) and anterolateral-posteromedial (-10.5%, p < 0.001) diameters. A greater reduction was noted in the anterior annulus length compared to the posterior annulus length (10.5% versus 6.2%, p < 0.05) after AVR. No significant change was seen in the non-planarity angle, coaptation depth, and closure line length. During the period of data acquisition before and after AVR, no significant change was noted in the central venous pressure or left ventricular end-diastolic diameter. CONCLUSION: The mitral annulus undergoes significant geometric changes immediately after AVR. Notably, a 16.3% reduction was observed in the mitral annular area. The anterior annulus underwent a greater reduction in length compared to the posterior annulus, which suggested the existence of a mechanical compression by the prosthetic valve.
BACKGROUND AND AIM OF THE STUDY: Intraoperative real-time three-dimensional transesophageal echocardiography (RT-3D TEE) was used to examine the geometric changes that occur in the mitral annulus immediately after aortic valve replacement (AVR). METHODS: A total of 35 patients undergoing elective surgical AVR under cardiopulmonary bypass was enrolled in the study. Intraoperative RT-3D TEE was used prospectively to acquire volumetric echocardiographic datasets immediately before and after AVR. The 3D echocardiographic data were analyzed offline using TomTec Mitral Valve Assessment software to assess changes in specific mitral annular geometric parameters. RESULTS: Datasets were successfully acquired and analyzed for all patients. A significant reduction was noted in the mitral annular area (-16.3%, p < 0.001), circumference (-8.9%, p < 0.001) and the anteroposterior (-6.3%, p = 0.019) and anterolateral-posteromedial (-10.5%, p < 0.001) diameters. A greater reduction was noted in the anterior annulus length compared to the posterior annulus length (10.5% versus 6.2%, p < 0.05) after AVR. No significant change was seen in the non-planarity angle, coaptation depth, and closure line length. During the period of data acquisition before and after AVR, no significant change was noted in the central venous pressure or left ventricular end-diastolic diameter. CONCLUSION: The mitral annulus undergoes significant geometric changes immediately after AVR. Notably, a 16.3% reduction was observed in the mitral annular area. The anterior annulus underwent a greater reduction in length compared to the posterior annulus, which suggested the existence of a mechanical compression by the prosthetic valve.
Authors: K M Harris; D J Malenka; M F Haney; J E Jayne; B Hettleman; J F Plehn; B P Griffin Journal: Am J Cardiol Date: 1997-09-15 Impact factor: 2.778
Authors: Feroze Mahmood; Joseph H Gorman; Balachundhar Subramaniam; Robert C Gorman; Peter J Panzica; Robert C Hagberg; Adam B Lerner; Philip E Hess; Andrew Maslow; Kamal R Khabbaz Journal: Ann Thorac Surg Date: 2010-10 Impact factor: 4.330
Authors: Nicolas M Van Mieghem; Nicolo Piazza; Robert H Anderson; Apostolos Tzikas; Koen Nieman; Lotte E De Laat; Jackie S McGhie; Marcel L Geleijnse; Ted Feldman; Patrick W Serruys; Peter P de Jaegere Journal: J Am Coll Cardiol Date: 2010-08-17 Impact factor: 24.094
Authors: Emmanuel Lansac; Khee Hiang Lim; Yu Shomura; Wolfgang A Goetz; Hou Sen Lim; Nolan T Rice; Hashim Saber; Carlos M G Duran Journal: J Thorac Cardiovasc Surg Date: 2002-05 Impact factor: 5.209
Authors: Feroze Mahmood; Balachundhar Subramaniam; Joseph H Gorman; Robert M Levine; Robert C Gorman; Andrew Maslow; Peter J Panzica; Robert M Hagberg; Swaminathan Karthik; Kamal R Khabbaz Journal: Ann Thorac Surg Date: 2009-12 Impact factor: 4.330
Authors: Feroze Mahmood; Swaminathan Karthik; Balachundhar Subramaniam; Peter J Panzica; John Mitchell; Adam B Lerner; Karinne Jervis; Andrew D Maslow Journal: J Cardiothorac Vasc Anesth Date: 2008-04 Impact factor: 2.628