Three-dimensional echocardiographic evaluation of configuration and dynamics of the mitral annulus in patients fitted with an annuloplasty ring.
OBJECTIVE
Three-dimensional (3D) echocardiography permits the objective analysis of structures and of pathologic conditions of complex geometry. Multiplane transesophageal echocardiography (TEE) permits 3D image sets of the heart to be produced from multiple 2D images by rotating the transducer, without changing its position. The purpose of this study was to clarify the capability of 3D echocardiography to evaluate the configuration and dynamics of the mitral annulus in patients fitted with an annuloplasty ring.


METHODS
Twenty patients who underwent mitral valve repair for pure mitral regurgitation (10 with a flexible Duran ring and 10 with a rigid Carpentier ring) were studied. Using a multiplane transesophageal probe, sequential tomographic images were obtained by rotating the transducer at 2 degrees angular intervals around a 180 degrees arc. 3D reconstructions were performed to produce dynamic 3D images of the mitral annulus in a manner that simulated visualization from the left atrium. Mitral annular configuration was assessed from volume-rendered display and extractive 3D imaging. Mitral annular area change was evaluated from selected long-axis cut planes.


RESULTS
The configuration and dynamics of the mitral annulus were visualized by 3D displays. In patients with a Duran ring, the mitral annulus had a non-planar configuration and mitral annular area changed during cardiac cycle (increased in diastole; reduced in atrial and ventricular systole; percentage reduction 25 +/- 2%). In patients with a Carpentier ring, the mitral annulus had a planar configuration and mitral annular area was effectively unchanged during the cardiac cycle.


CONCLUSIONS
3D echocardiography using a multiplane transesophageal probe is useful in evaluating the configuration and dynamics of the mitral annulus in patients fitted with an annuloplasty ring.
Yamaura
Y
Y
Division of Cardiology and Cardiovascular Surgery, Kobe General Hospital, Japan.
Yoshida
K
K
Hozumi
T
T
Akasaka
T
T
Okada
Y
Y
Yoshikawa
J
J
D000328:Adult; D000368:Aged; D003971:Diastole / Q000502:physiology; D019560:Echocardiography, Three-Dimensional; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000503:physiopathology*; D008944:Mitral Valve Insufficiency / Q000601:surgery; D013599:Systole / Q000502:physiology