Three-dimensional analysis of configuration and dynamics in patients with an annuloplasty ring by multiplane transesophageal echocardiography: comparison between flexible and rigid annuloplasty rings.

BACKGROUND AND AIM OF THE STUDY

Multiplane transesophageal echocardiography provides three-dimensional reconstruction of the mitral annulus from multiple cross-sectional views from a stable transducer position by rotating around a central axis. This study was designed to evaluate the effect of the type of annuloplasty ring on mitral annular configuration and dynamics using three-dimensional reconstruction by multiplane transesophageal echocardiography.

METHODS

Ten patients who underwent mitral valve repair for pure mitral regurgitation (five patients with flexible Duran ring, five patients with rigid Carpentier ring) and five normal subjects were studied with multiplane transesophageal echocardiography. Three-dimensional configuration of the mitral annulus was obtained from multiple cross-sectional views of multiplane transesophageal echocardiography.

RESULTS

In normal subjects, the mitral annulus had a non-planar configuration and reduced its area in systole. In patients with a Duran ring, the mitral annulus had a non-planar configuration and reduced its area in systole. In patients with a Carpentier ring, the mitral annulus had a planar configuration and the mitral annular area did not change during the cardiac cycle.

CONCLUSION

Three dimensional reconstruction of the mitral annulus using multiplane transesophageal echocardiography revealed that mitral annular configuration and dynamics are more physiologic in patients with a flexible Duran ring that with a rigid Carpentier ring.