The Intraoperative 4D Transesophageal Echocardiography in Patients with Organic Mitral Valve Insufficiency

Nadezhda O. Sokolskaya, Ivan I. Skopin, Natalia S. Kopylova, Elena V. Skripnik, Alexey V. Ivanov

A.N. Bakoulev Scientific Center for Cardiovascular Surgery, Moscow, Russia

Date, time and location: 2018.05.27 08:30, Congress Hall, 2F–A

Abstract

Objectives: to study the work of intraoperative 4D transesophageal echocardiography in patients with organic mitral valve insufficiency.

Materials and methods: there were 20 patients with organic mitral valve insufficiency, 19 with myxomatous degeneration and 1-congenital defect (cleavage of the anterior mitral valve leaflet). The average age was 57 years. The following parameters were assessed: end-diastolic (EDI), end-systolic (ESI), systolic output indexes (SOI), ejection fraction (EF), LV cardiac index, RV end-diastolic dimension (EDD), calculated RV systolic pressure.

Results: the received datademonstrated good LV myocardium pumping function and increased volume parameters. EDI was 81±21 ml / m², ESI was31±8 ml / m²,SOI 50±17 ml / m². LV EF was 61%. It was noted the increasing offollowing parameters: the left atrium to 50 ± 15 mm, EDD to 45 ± 2 mm and RA lateral size to 45 ± 6 mm. The calculated RV systolic pressure was 45 ± 13 mm Hg. The mitral and tricuspid valve insufficiency was severe. The mitral annulus was increased to 40 ± 5 mm and tricuspid annulus to 42 ± 4 mm. The morphological structure consisted of mitral prolapsed-11 patients, rupture of chordae tendineae- 5, cleavage of the posterior-4 and anterior -1 mitral valve leaflet.

Based on the data of 4D IT echocardiography all patients underwent the MV reconstruction. In all patients volume parameters were decreased and there were no mitral and tricuspid valve insufficiency.

Conclusion: the4D IT echocardiography allow to assess the myocardium function and MV morphological structure anddetermine the operation strategy and evaluate the result of the performed reconstruction.