Usefulness of three-dimensional echocardiography for the evaluation of mitral valve prolapse: An intraoperative study

Background and aim of the study: The study aim was to evaluate the feasibil ity of intraoperative three-dimensional (3D) transesophageal echocardiograp hy (TEE) in patients referred for mitral valve prolapse (MVP) repair and to compare two-dimensional (2D) TEE and 3D TEE and surgical findings. Methods: Forty-six patients (mean age 67 +/- 11 years) underwent 3D TEE int raoperatively. Measurements were made of the posterior part of mitral annul us circumference (PMAC), and the width of mitral valve surgical resection o n the mitral annulus (WMVR). Using 3D TEE, MVP topography was described, an d PMAC in diastole and the width of implantation of MVP on the mitral annul us (WMVP) in systole were measured. Results: 3D TEE was successful in 42 patients (91%). 2D and 3DTEE correctly predicted MVP localization in 38 (90%) and 36 (86%) patients, respectively (p = NS). 3D TEE and surgical PMAC were 89 +/- 13 and 93 +/- 21 mm, respec tively (p = 0.01, R = 0.42). WMVR and WMVP were 28 +/- 11 mm and 26 +/- 11 mm, respectively (p <0.0001, R = 0.82). WMVR/anatomic PMAC (0.29 +/- 0.11) and WMVP/3D echo PMAC (0.32 +/- 0.11) were correlated (p <0.0001, R = 0.69) . Conclusion: Intraoperative 3D TEE evaluation of MVP is feasible. MVP width and its ratio to the mitral annulus were assessed, and found to correlate w ith surgical findings. These 3D data may be of value to the surgeon when pe rforming mitral valve repair.