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Dynamic indices of mitral valve function using perioperative three-dimensional transesophageal echocardiography.

Publication ,  Journal Article
Bartels, K; Thiele, RH; Phillips-Bute, B; Glower, DD; Swaminathan, M; Kisslo, J; Burkhard Mackensen, G
Published in: J Cardiothorac Vasc Anesth
February 2014

OBJECTIVE: Perioperative transesophageal echocardiography is essential for decision-making for mitral valve surgery. While two-dimensional transesophageal echocardiography represents the standard of care, tracking of dynamic changes using three-dimensional imaging permits assessment of morphologic and functional characteristics of the mitral valve. The authors hypothesized that quantitative three-dimensional analysis would reveal distinct differences among diseased, repaired, and normal mitral valves. DESIGN: Case-control observational clinical study. SETTING: Tertiary care hospital. PARTICIPANTS: Using novel mitral valve quantification software, the authors retrospectively analyzed 80 datasets of cardiac surgery patients who underwent intraoperative transesophageal echocardiographic imaging. Twenty patients with degenerative mitral regurgitation were evaluated before and after mitral valve repair. Twenty patients had functional mitral regurgitation, and 20 patients had no mitral valve disease. MEASUREMENTS AND MAIN RESULTS: Primary outcome measures of dynamic mitral valve function were: 1) three-dimensional annulus area, 2) annular displacement distance, 3) annular displacement velocity, and 4) annular area fraction. Other mitral annular tracking indices, in addition to intraobserver reliability and interobserver agreement, also were reported. Annulus area was enlarged in degenerative and functional mitral regurgitation. Annular displacement distance was decreased in functional mitral regurgitation and repaired valves. Annular displacement velocity was decreased in functional mitral regurgitation. Annular area fraction was decreased in functional mitral regurgitation and repaired valves. Intraobserver reliability and interobserver agreement were high for all 4 analyzed indices. CONCLUSIONS: Normal, functional regurgitant, degenerative, and repaired mitral valves have distinctly different dynamic signatures of anatomy and function as reliably determined by perioperative echocardiographic tracking.

Duke Scholars

Published In

J Cardiothorac Vasc Anesth

DOI

EISSN

1532-8422

Publication Date

February 2014

Volume

28

Issue

1

Start / End Page

18 / 24

Location

United States

Related Subject Headings

  • Perioperative Care
  • Mitral Valve Insufficiency
  • Mitral Valve
  • Middle Aged
  • Male
  • Humans
  • Female
  • Echocardiography, Transesophageal
  • Echocardiography, Three-Dimensional
  • Case-Control Studies
 

Citation

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Bartels, K., Thiele, R. H., Phillips-Bute, B., Glower, D. D., Swaminathan, M., Kisslo, J., & Burkhard Mackensen, G. (2014). Dynamic indices of mitral valve function using perioperative three-dimensional transesophageal echocardiography. J Cardiothorac Vasc Anesth, 28(1), 18–24. https://doi.org/10.1053/j.jvca.2013.03.024
Bartels, Karsten, Robert H. Thiele, Barbara Phillips-Bute, Donald D. Glower, Madhav Swaminathan, Joseph Kisslo, and G. Burkhard Mackensen. “Dynamic indices of mitral valve function using perioperative three-dimensional transesophageal echocardiography.J Cardiothorac Vasc Anesth 28, no. 1 (February 2014): 18–24. https://doi.org/10.1053/j.jvca.2013.03.024.
Bartels K, Thiele RH, Phillips-Bute B, Glower DD, Swaminathan M, Kisslo J, et al. Dynamic indices of mitral valve function using perioperative three-dimensional transesophageal echocardiography. J Cardiothorac Vasc Anesth. 2014 Feb;28(1):18–24.
Bartels, Karsten, et al. “Dynamic indices of mitral valve function using perioperative three-dimensional transesophageal echocardiography.J Cardiothorac Vasc Anesth, vol. 28, no. 1, Feb. 2014, pp. 18–24. Pubmed, doi:10.1053/j.jvca.2013.03.024.
Bartels K, Thiele RH, Phillips-Bute B, Glower DD, Swaminathan M, Kisslo J, Burkhard Mackensen G. Dynamic indices of mitral valve function using perioperative three-dimensional transesophageal echocardiography. J Cardiothorac Vasc Anesth. 2014 Feb;28(1):18–24.
Journal cover image

Published In

J Cardiothorac Vasc Anesth

DOI

EISSN

1532-8422

Publication Date

February 2014

Volume

28

Issue

1

Start / End Page

18 / 24

Location

United States

Related Subject Headings

  • Perioperative Care
  • Mitral Valve Insufficiency
  • Mitral Valve
  • Middle Aged
  • Male
  • Humans
  • Female
  • Echocardiography, Transesophageal
  • Echocardiography, Three-Dimensional
  • Case-Control Studies