Assessment of successful valve reconstruction by intraoperative transesophageal echocardiography (TEE).
In 17 patients (10 patients with mitral insufficiency, 5 patients with tricuspid regurgitation, 2 patients with mitral stenosis) the result of valve reconstruction was evaluated by intraoperative two-dimensional transesophageal contrast-echocardiography (TEE). Therefore, 1-2cc of an agitated contrast-medium (Gelifundol) were injected into the left or right ventricle. The result of reconstruction was assessed by the extent of regurgitant microbubbles into the left or right atrium. A successful valve repair could be demonstrated in 15 patients without or with only minimal regurgitation of contrast-fluid. In one patient residual severe mitral insufficiency after valve reconstruction could only be detected when valve function was examined by contrast-TEE in the beating heart. An intraoperative decision for valve replacement was made. In another patient, mild to moderate residual mitral incompetence was shown; no further surgical intervention was done. By TEE the function of reconstructed valves can be examined under physiological conditions in the beating heart. Surgeons can obtain additional intra-operatively information and certainty about the result of reconstruction and an early decision for valve replacement can be made if necessary.
Drexler
M
M
II. Medical Clinic, Johannes Gutenberg-University, Mainz, FRG.
Erbel
R
R
Dahm
M
M
Mohr-Kahaly
S
S
Oelert
H
H
Meyer
J
J
D000328:Adult; D000368:Aged; D004452:Echocardiography / Q000379:methods*; D004947:Esophagus; D005260:Female; D006351:Heart Valves / Q000601:surgery*; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged