Abstract
Introduction: Transthoracic echocardiography (TTE) is the most beneficial diagnostic modality for mitral valve (MV) diseases. However, it is not accurate enough for MV annular sizing. Recent evidence has demonstrated the superiority of transesophageal echocardiography (TEE) over TTE. The present study aimed to evaluate the accuracy of two-dimensional TEE (2D-TEE) and three-dimensional TEE (3D-TEE) in preoperative measuring of MV size and specifications.
Methods: This cross-sectional study evaluated patients with mitral valve replacement (MVR) surgery at Shahid Madani Heart Center of Tabriz university of Medical Sciences, Tabriz, Iran, in 2020. Thirty-eight patients admitted for MVR surgery were enrolled in this study. Demographic, electrocardiogram (ECG), and echocardiographic studies -including TTE, 2D, and 3D TEE- were performed preoperative for each patient. The accurate size and the specifications of the studied structure were measured by a surgical gauge caliper during the surgery, which was considered the gold standard value. The correlations between obtained parameters were evaluated using Pearson’s correlation coefficient. The data obtained from individual were entered into the SPSS software. Significance was set at P<0.05.
Results: The mean age of patients was 55.89±11.81 years, and 65.8% were male. Most patients (68.4%) had sinus rhythm. The strongest correlation with the gold standard was observed in mitral annulus circumference measured by the three-dimensional multiplanar reconstruction (3D MPR) method in all patients (r=0.758, P<0.001), [(r=0.723, P<0.001) for patients with sinus rhythm, and (r=0.825, P=0.001) for patients with atrial fibrillation (AF)]. The minor difference between the echocardiographic measurements and the surgical rule was related to the short axis (SA) in the 3D MPR method (3.3 mm).
Conclusion: This study illustrated a high correlation between 3D-MPR TEE measured MV annulus and intra-operative measurements using a surgical gauge caliper as the gold standard.