Comparison Of Three Dimensional Echocardiographic Measurements And In Vivo Analysis Of The Tricuspid Valve During Mitral Valve Surgery
Matteo Pettinari1, Siham Lazam2, Laurent De Kerchove2, Agnes Pasquet2, Bernard Gerber2, Gebrine El-Khoury El-Khoury2, Jean-Louis Vanoverschelde2.
1Ziekenhuis Oost Limburg, Genk, Belgium, 2Universitair Clinique St. Luc, Brussel, Belgium.
OBJECTIVE: Tricuspid valve is a complex three dimensional structure. 2D and 3D echocardiography are the gold standard instruments to evaluate its function and anatomy. In vivo analysis and measurement of the annulus and leaflet are lacking. Aim of our study is to compare in vivo with 3D echocardiographic measurements of the tricuspid valve in patients treated for mitral valve disease.
METHODS: Among 139 patients treated for mitral valve disease, 37 had an intraoperative evaluation by 3D transoesophageal echocardiography and after exposure of the valve several pictures were taken to obtain annular and leaflet measurements. Echocardiographic annular measurements (area, perimeter, antero-septal and latero-posterior diameters) were obtained in six different moment of the cardiac cycle: early mid and late, systole and diastole. Maximal leaflets length and area were measured in end-systole and early diastole. The annular and leaflet measurement were extracted from the intraoperative pictures and compared to the echocardiographic finding by a Pearson correlation test.
RESULTS: Significant correlation were found between 3D echocardiography and in vivo measurement in term of valve area (p<0.01, r=0.77), perimeter (p<0.01, r=0.61), antero-septal (p<0.01, r=0.6) and latero-posterior diameter (p<0.01, r=0.64), anterior and posterior leaflet area (p<0.01, r=0.63), septal leaflet area (p<0.01, r=0.69), anterior (p=0.03, r=0.64) and posterior leaflet length (p=0.03, t=0.67).
CONCLUSIONS: Our study demonstrates a moderate to good correlation between in vivo and 3D echocardiographic measurement of tricuspid valve annulus and leaflet. Further studies are needed to investigate their impact on recurrence of tricuspid valve insufficiency
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