Sizing of mitral annuloplasty rings using real-time three-dimensional transesophageal echocardiography and the differenc
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ORIGINAL INVESTIGATION
Sizing of mitral annuloplasty rings using real‑time three‑dimensional transesophageal echocardiography and the difference between patients with and without recurrent mitral regurgitation: retrospective cohort study Tasuku Fujii1,2 · Kenji Yoshitani1 · Eiki Kanemaru1 · Michikazu Nakai3 · Kunihiro Nishimura3 · Yoshihiko Ohnishi1 · Kimitoshi Nishiwaki2 Received: 17 October 2019 / Revised: 8 February 2020 / Accepted: 25 February 2020 © Japanese Society of Echocardiography 2020
Abstract Background Previous studies showed that the mitral inter-commissural (IC) distance differed by a few millimeters between the systolic and diastolic cardiac cycles. However, sizing of the mitral annuloplasty ring with a ring sizer, which should be performed in the systole, is performed in diastole during hyperkalemic cardioplegic arrest. The aim of this study was to investigate whether three-dimensional transesophageal echocardiography (3D-TEE) measurements of the mitral valve in end-systole are effective to determine the size of the annuloplasty ring. Methods This study retrospectively reviewed 92 patients who underwent mitral annuloplasty for degenerative. The IC distance and anterior leaflet height of the A2 segment of the mitral valve were measured by 3D-TEE at the end-systole. The annuloplasty ring size was measured by the surgeons using specific ring sizers. We compared the IC distance measured by 3D-TEE with the implanted annuloplasty size. We also investigated differences in IC distance, A2 height, and ratio of A2 height to IC distance in patients with and without recurrent mild to moderate MR for 36 months. Results There was a significant correlation between the IC distance by 3D-TEE and the implanted ring size (R2 = 0.7023, p
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