Evaluarea mecanismului regurgitării mitrale severe prin utilizarea ecocardiografiei tridimensionale; comparație cu aspectul intraoperator

Abstract

Background: Bidimensional echocardiography is commonly used to assess mitral valve morphology in patients with severe regurgitation but could miss important abnormalities. Objective: Is to analyze the place of three dimensional echocardiography for the assessment of severe mitral regurgitation mecanism before the surgery. Methods: Detailed 3D assessment was done on 48 consecutive patients with severe mitral regurgitation undergoing mitral valve surgery. En-face and longitudinal views were compared for detection and location of primary pathology. Results: Recognition of valve structure was significantly better with longitudinal reconstruction for both mitral leaflets but not for the commissures. Accurate identification of pathology with three dimensional echocardiography was possible in 93% cases (91% for longitudinal views, compared with 60% for en-face reconstruction. Conclusion: three dimensional echocardiography is useful for the assessment of severe mitral regurgitation mechanism before the surgery. En-face reconstructions alone are inadequate. Additional longitudinal reconstructions are necessary to ensure full inspection of valve morphology.