Ender J, Eibel S, Mukherjee C, Mathioudakis D, Borger M A, Jacobs S, Mohr F W, Falk V
Department of Anaesthesiology and Intensive Care Medicine II, Leipzig Heart Center, University of Leipzig, Struempellstrasse 39, 04289 Leipzig, Germany.
Eur J Echocardiogr. 2011 Jun;12(6):445-53. doi: 10.1093/ejechocard/jer042. Epub 2011 May 4.
We sought to investigate the additional value of real-time three-dimensional transoesophageal echocardiography (RT 3D TOE)-guided sizing for predicting annuloplasty ring size during mitral valve repair.
In 53 patients undergoing elective mitral valve repair, an RT 3D TOE was performed pre- and post-operatively. The digitally stored loops were imported into a software for mitral valve assessment. The annuloplasty ring size was predicted by superimposing computer-aided design (CAD) models of annuloplasty rings onto Live 3D zoom loops, measurement of the intercommissural distance, or the height of the anterior mitral leaflet. The surgeon implanted the annuloplasty ring according to the usual surgical technique and was blinded to the echocardiographic measurement results. Pre-operative correlation between the selected ring size with mitral valve assessment and the actual implanted annuloplasty ring size was 0.91. The correlation for measurement of the intercommissural distance was 0.55 and for measurement of the height of the anterior mitral leaflet 0.75. The post-operative correlation with the actual implanted ring size was 0.96 for mitral valve assessment, 0.92 for intercommissural distance, and 0.79 for the anterior mitral leaflet height.
Superimposition of annuloplasty ring CAD models on the Live 3D zoom loops of the mitral valve using mitral valve assessment is superior to two-dimensional measurements of the intercommissural distance or the height of the anterior mitral leaflet in predicting correct annuloplasty ring size.
我们旨在研究实时三维经食管超声心动图(RT 3D TOE)引导下测量在预测二尖瓣修复术中瓣环成形环尺寸方面的附加价值。
对53例行择期二尖瓣修复术的患者在术前和术后进行了RT 3D TOE检查。将数字存储的环导入用于二尖瓣评估的软件中。通过将瓣环成形环的计算机辅助设计(CAD)模型叠加到实时三维缩放环上、测量瓣间距离或二尖瓣前叶高度来预测瓣环成形环尺寸。外科医生按照常规手术技术植入瓣环成形环,且对超声心动图测量结果不知情。所选环尺寸与二尖瓣评估之间的术前相关性与实际植入的瓣环成形环尺寸为0.91。瓣间距离测量的相关性为0.55,二尖瓣前叶高度测量的相关性为0.75。术后与实际植入环尺寸的相关性,二尖瓣评估为0.96,瓣间距离为0.92,二尖瓣前叶高度为0.79。
使用二尖瓣评估将瓣环成形环CAD模型叠加在二尖瓣的实时三维缩放环上,在预测正确的瓣环成形环尺寸方面优于瓣间距离或二尖瓣前叶高度的二维测量。