Intraoperative application of geometric three-dimensional mitral valve assessment package: a feasibility study.
OBJECTIVE
To study the feasibility of using 3-dimensional (3D) echocardiography in the operating room for mitral valve repair or replacement surgery. To perform geometric analysis of the mitral valve before and after repair.


METHODS
Prospective observational study.


METHODS
Academic, tertiary care hospital.


METHODS
Consecutive patients scheduled for mitral valve surgery.


METHODS
Intraoperative reconstruction of 3D images of the mitral valve.


RESULTS
One hundred and two patients had 3D analysis of their mitral valve. Successful image reconstruction was performed in 93 patients-8 patients had arrhythmias or a dilated mitral valve annulus resulting in significant artifacts. Time from acquisition to reconstruction and analysis was less than 5 minutes. Surgeon identification of mitral valve anatomy was 100% accurate.


CONCLUSIONS
The study confirms the feasibility of performing intraoperative 3D reconstruction of the mitral valve. This data can be used for confirmation and communication of 2-dimensional data to the surgeons by obtaining a surgical view of the mitral valve. The incorporation of color-flow Doppler into these 3D images helps in identification of the commissural or perivalvular location of regurgitant orifice. With improvements in the processing power of the current generation of echocardiography equipment, it is possible to quickly acquire, reconstruct, and manipulate images to help with timely diagnosis and surgical planning.
Mahmood
Feroze
F
Department of Anesthesia and Critical Care, Beth Israel Deaconess Medical Center, Boston, MA, USA.
Karthik
Swaminathan
S
Subramaniam
Balachundhar
B
Panzica
Peter J
PJ
Mitchell
John
J
Lerner
Adam B
AB
Jervis
Karinne
K
Maslow
Andrew D
AD
D019560:Echocardiography, Three-Dimensional / Q000379:methods* / Q000592:standards; D005240:Feasibility Studies; D019918:Heart Valve Prosthesis Implantation / Q000379:methods / Q000592:standards; D006801:Humans; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery; D016343:Monitoring, Intraoperative / Q000379:methods* / Q000592:standards; D011446:Prospective Studies