title: Pre-operative transthoracic real-time three-dimensional echocardiography in patients undergoing mitral valve repair: accuracy in cases with simple vs. complex prolapse lesions.
abstract: OBJECTIVE
  The aim of this study, undertaken in patients who underwent mitral valve (MV) repair surgery, was to evaluate the accuracy of pre-operative three-dimensional (3D) transthoracic echocardiography (TTE) in the evaluation of MV pathology in cases with simple or complex lesions.
  
  
  RESULTS
  Two hundred consecutive patients with severe mitral regurgitation due to degenerative MV prolapse underwent a complete 3DTTE the day before surgery. Three-dimensional TTE data were compared with MV surgical inspection. Three-dimensional echocardiography was feasible in a relatively short time (5 ± 3 min) with good (67%) and optimal (21%) imaging quality in the majority of cases. Three-dimensional TTE allowed an accurate identification (95% accuracy) of all MV lesions. Seventy-three (36.5%) patients had simple lesions at 3DTTE and 71 of them (97.2%) underwent a simple surgical procedure; 127 (63.5%) had complex lesions at 3DTTE and, in these cases, surgeons performed either simple procedures (48%) or complex procedures (47.2%) or valve replacement in 4.7% (after a first attempt for repair).
  
  
  CONCLUSIONS
  Three-dimensional TTE is feasible, not time-consuming, and accurate in identifying cases with simple vs. complex MV lesions.
authors.affiliation: Centro Cardiologico Monzino, IRCCS, Department of Cardiovascular Sciences, University of Milan, Via Parea 4, 20138 Milan, Italy. gloria.tamborini@ccfm.it
authors.forename: Gloria
authors.initials: G
authors.lastname: Tamborini
authors.forename: Manuela
authors.initials: M
authors.lastname: Muratori
authors.forename: Anna
authors.initials: A
authors.lastname: Maltagliati
authors.forename: Claudia Agnese
authors.initials: CA
authors.lastname: Galli
authors.forename: Moreno
authors.initials: M
authors.lastname: Naliato
authors.forename: Marco
authors.initials: M
authors.lastname: Zanobini
authors.forename: Francesco
authors.initials: F
authors.lastname: Alamanni
authors.forename: Luca
authors.initials: L
authors.lastname: Salvi
authors.forename: Erminio
authors.initials: E
authors.lastname: Sisillo
authors.forename: Cesare
authors.initials: C
authors.lastname: Fiorentini
authors.forename: Mauro
authors.initials: M
authors.lastname: Pepi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D008945:Mitral Valve Prolapse / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D011300:Preoperative Care; D012680:Sensitivity and Specificity; D016896:Treatment Outcome