title: Usefulness of three-dimensional echocardiography for the evaluation of mitral valve prolapse: an intraoperative study.
abstract: OBJECTIVE
  The study aim was to evaluate the feasibility of intraoperative three-dimensional (3D) transesophageal echocardiography (TEE) in patients referred for mitral valve prolapse (MVP) repair and to compare two-dimensional (2D) TEE and 3D TEE and surgical findings.
  
  
  METHODS
  Forty-six patients (mean age 67 +/- 11 years) underwent 3D TEE intraoperatively. Measurements were made of the posterior part of mitral annulus circumference (PMAC), and the width of mitral valve surgical resection on the mitral annulus (WMVR). Using 3D TEE, MVP topography was described, and PMAC in diastole and the width of implantation of MVP on the mitral annulus (WMVP) in systole were measured.
  
  
  RESULTS
  3D TEE was successful in 42 patients (91%). 2D and 3DTEE correctly predicted MVP localization in 38 (90%) and 36 (86%) patients, respectively (p = NS). 3D TEE and surgical PMAC were 89 +/- 13 and 93 +/- 21 mm, respectively (p = 0.01, R = 0.42). WMVR and WMVP were 28 +/- 11 mm and 26 +/- 11 mm, respectively (p <0.0001, R = 0.82). WMVR/anatomic PMAC (0.29 +/- 0.11) and WMVP/3D echo PMAC (0.32 +/- 0.11) were correlated (p <0.0001, R= 0.69).
  
  
  CONCLUSIONS
  Intraoperative 3D TEE evaluation of MVP is feasible. MVP width and its ratio to the mitral annulus were assessed, and found to correlate with surgical findings. These 3D data may be of value to the surgeon when performing mitral valve repair.
authors.affiliation: Clinique Saint-Augustin, Bordeaux, France.
authors.forename: C
authors.initials: C
authors.lastname: Chauvel
authors.forename: E
authors.initials: E
authors.lastname: Bogino
authors.forename: P
authors.initials: P
authors.lastname: Clerc
authors.forename: G
authors.initials: G
authors.lastname: Fernandez
authors.forename: J C
authors.initials: JC
authors.lastname: Vernhet
authors.forename: A
authors.initials: A
authors.lastname: Becat
authors.forename: P
authors.initials: P
authors.lastname: Dehant
mesh_terms: D000368:Aged; D002815:Chordae Tendineae / Q000473:pathology; D004452:Echocardiography; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D005240:Feasibility Studies; D006801:Humans; D007430:Intraoperative Care; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000473:pathology; D008945:Mitral Valve Prolapse / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D015203:Reproducibility of Results; D012421:Rupture; D012680:Sensitivity and Specificity