title: Prediction of the annuloplasty ring size in patients undergoing mitral valve repair using real-time three-dimensional transoesophageal echocardiography.
abstract: OBJECTIVE
  We sought to investigate the additional value of real-time three-dimensional transoesophageal echocardiography (RT 3D TOE)-guided sizing for predicting annuloplasty ring size during mitral valve repair.
  
  
  RESULTS
  In 53 patients undergoing elective mitral valve repair, an RT 3D TOE was performed pre- and post-operatively. The digitally stored loops were imported into a software for mitral valve assessment. The annuloplasty ring size was predicted by superimposing computer-aided design (CAD) models of annuloplasty rings onto Live 3D zoom loops, measurement of the intercommissural distance, or the height of the anterior mitral leaflet. The surgeon implanted the annuloplasty ring according to the usual surgical technique and was blinded to the echocardiographic measurement results. Pre-operative correlation between the selected ring size with mitral valve assessment and the actual implanted annuloplasty ring size was 0.91. The correlation for measurement of the intercommissural distance was 0.55 and for measurement of the height of the anterior mitral leaflet 0.75. The post-operative correlation with the actual implanted ring size was 0.96 for mitral valve assessment, 0.92 for intercommissural distance, and 0.79 for the anterior mitral leaflet height.
  
  
  CONCLUSIONS
  Superimposition of annuloplasty ring CAD models on the Live 3D zoom loops of the mitral valve using mitral valve assessment is superior to two-dimensional measurements of the intercommissural distance or the height of the anterior mitral leaflet in predicting correct annuloplasty ring size.
authors.affiliation: Department of Anaesthesiology and Intensive Care Medicine II, Leipzig Heart Center, University of Leipzig, Struempellstrasse 39, 04289 Leipzig, Germany. joerg.ender@medizin.uni-leipzig.de
authors.forename: J
authors.initials: J
authors.lastname: Ender
authors.forename: S
authors.initials: S
authors.lastname: Eibel
authors.forename: C
authors.initials: C
authors.lastname: Mukherjee
authors.forename: D
authors.initials: D
authors.lastname: Mathioudakis
authors.forename: M A
authors.initials: MA
authors.lastname: Borger
authors.forename: S
authors.initials: S
authors.lastname: Jacobs
authors.forename: F W
authors.initials: FW
authors.lastname: Mohr
authors.forename: V
authors.initials: V
authors.lastname: Falk
mesh_terms: D003198:Computer Simulation; D017548:Echocardiography, Transesophageal / Q000295:instrumentation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D058386:Mitral Valve Annuloplasty / Q000295:instrumentation / Q000379:methods*; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008962:Models, Theoretical; D013223:Statistics as Topic