title: Multiplane two-dimensional versus real time three-dimensional transesophageal echocardiography in ischemic mitral regurgitation.
abstract: OBJECTIVE
  Intraoperative three-dimensional (3D) transesophageal echocardiography (TEE) has been suggested to be a valuable technique for the evaluation of the mechanisms of ischemic mitral regurgitation (IMR). Studies comparing multiplane two-dimensional (2D) with 3D TEE reconstruction of the mitral valve using the new mitral valve quantification (MVQ) software are lacking. We undertook a prospective comparison between multiplane 2D and 3D TEE for the assessment of IMR.
  
  
  METHODS
  We evaluated echocardiographically 45 patients with IMR who underwent mitral valve surgery in our institution. 2D and 3D TEE examinations followed by a 3D offline assessment of the mitral valve apparatus were performed in all patients. Offline analysis of mitral valve apparatus was conducted with QLAB-MVQ.
  
  
  RESULTS
  3D TEE image acquisitions were performed in a short period of time and were feasible in all patients. Real time 3D TEE imaging was superior to 2D in identifying specific mitral scallops (A1, A3, P1, P3) and commissures. When compared with 2D TEE, 3D offline reconstruction of the mitral valve allows an accurate quantification of the shape and diameters of the mitral annulus. Both approaches provide almost similar values for the tenting area and the coaptation depth. The 3D approach gave the advantage of direct calculation of the leaflets angles, tenting volume, and surface of the leaflets. The interpapillary muscles distance at the level of the papillary muscle head was greater in 2D than in 3D.
  
  
  CONCLUSIONS
  3D TEE imaging provides valuable and complementary information to multiplane 2D TEE for the assessment of patients with IMR.
authors: Department of Cardiac Surgery, University of Palermo, Palermo, Italy. khalilfattouch@hotmail.com
authors: Khalil
authors: K
authors: Fattouch
authors: Sebastiano
authors: S
authors: Castrovinci
authors: Giacomo
authors: G
authors: Murana
authors: Giuseppina
authors: G
authors: Novo
authors: Giuseppa
authors: G
authors: Caccamo
authors: Emanuela C
authors: EC
authors: Bertolino
authors: Roberta
authors: R
authors: Sampognaro
authors: Salvatore
authors: S
authors: Novo
authors: Giovanni
authors: G
authors: Ruvolo
authors: Patrizio
authors: P
authors: Lancellotti
mesh_terms: D000368:Aged; D003199:Computer Systems; D004452:Echocardiography / Q000379:methods*; D019560:Echocardiography, Three-Dimensional / Q000379:methods*; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008944:Mitral Valve Insufficiency / Q000150:complications* / Q000000981:diagnostic imaging*; D017202:Myocardial Ischemia / Q000000981:diagnostic imaging* / Q000209:etiology*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity