A Methodological Study On Mitral Valve Quantification Of TEE To Evaluate The Size Of The Annuloplasty Ring

Objectives:This study aims to apply the real-time three-dimensional transesophageal echocardiography combined with mitral valve quantification to quantitative analysis of the three-dimensional structure and function of the valve apparatus in patients with mitral valve diseases,thus to provide anatomic basis and dynamic data support for patients with mitral valve lesions in choosing surgical method and size of annuloplasty ring.Methods:According to the purpose of the study,30 patients undergoing mitral valvuloplasty in our hospital were collected and all patients underwent RT-3D-TEE before surgery.Mitral Valve quantitative analysis software(Mitral Valve Assessment)was applied to conduct quantitative analysis of mitral valve.Compared the size of annuloplasty ring predicted by three different methods with the size of the actual implanted ring during operation,and studied the accuracy of different methods.The correlation between the size of annuloplasty ring and the factors was analyzed by statistics.Results:1.The accuracy of the size of annuloplasty ring predicted by integrated approach was higher than that based solely on the length or area of the anterior leaflet.2.Paired chi-square test(Mc Nemar's test)was used to test the consistency between the size of annuloplasty ring predicted by the integrated approach and the size of the actual implanted ring during the operation,and the difference was not statistically significant(P>0.05).Kappa=0.94 indicated that the two methods selecting the size of annuloplasty ring were highly consistent.3.Spearman correlation analysis showed that the size of annuloplasty ring predicted by the integrated approach was significantly positively correlated with Commissural Diameter?AL-PM and A3D(the correlation indexes were r=0.644,0.655,0.542;P<0.01),and positively correlated with A_m Ant,L_m Ant and DAP(r=0.429,0.453 and0.443;P<0.05).Conclusions:Real-time three-dimensional transesophageal echocardiography combi ned with MVA analysis software was used to obtain specific parameters of mitral valve.There was a strong consistency between the size of an nuloplasty ring measured by intraoperative specific‘sizer'instruments a nd the size predicted by integrated approach which considering multiple factors such as commissural diameter,the length of anterior leaflet,the area of anterior leaflet and so on.The integrated approach will replace the intraoperative specific‘sizer'instruments to select appropriate size of annuloplasty ring soon.