Pre-operative transthoracic real-time three-dimensional echocardiography in patients undergoing mitral valve repair: accuracy in cases with simple vs. complex prolapse lesions.
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.
Tamborini
Gloria
G
Centro Cardiologico Monzino, IRCCS, Department of Cardiovascular Sciences, University of Milan, Via Parea 4, 20138 Milan, Italy. gloria.tamborini@ccfm.it
Muratori
Manuela
M
Maltagliati
Anna
A
Galli
Claudia Agnese
CA
Naliato
Moreno
M
Zanobini
Marco
M
Alamanni
Francesco
F
Salvi
Luca
L
Sisillo
Erminio
E
Fiorentini
Cesare
C
Pepi
Mauro
M
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