MULTIPLANE TRANSESOPHAGEAL ECHOCARDIOGRAPHIC IDENTIFICATION OF THE INVOLVED SCALLOP IN PATIENTS WITH FLAIL MITRAL-VALVE LEAFLET - INTRAOPERATIVE CORRELATION

Although the role of multiplane transesophageal echocardiography in th e diagnosis of flail mitral valve leaflet is well described, the accur acy of this modality in localizing the involved posterior leaflet scal lop (medial middle, or lateral) has never been validated. For 54 patie nts undergoing intraoperative transesophageal echocardiography for sev ere mitral regurgitation due to flail mitral valve leaflet, we assesse d the accuracy of a systematic approach to localization of the flail m itral valve leaflet. Surgical confirmation was performed for all patie nts. At blinded review, a sensitivity of 78%, specificity of 92%, and overall diagnostic: accuracy of 88% were achieved for correct localiza tion of the flail posterior leaflet scallop. The middle scallop was mo st commonly affected in this series. The medial scallop was affected l east often, and diagnosis of lesions in that area was least accurate. This diagnostic approach appears to be accurate and feasible and may a ssist in planning specific surgical therapy for this disorder.