Alison M. Pouch, PhD, Benjamin M

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Presentation transcript:

Modeling the Myxomatous Mitral Valve With Three-Dimensional Echocardiography Alison M. Pouch, PhD, Benjamin M. Jackson, MD, Eric Lai, BS, Manabu Takebe, MD, Sijie Tian, MS, Albert T. Cheung, MD, Y. Joseph Woo, MD, Prakash A. Patel, MD, Hongzhi Wang, PhD, Paul A. Yushkevich, PhD, Robert C. Gorman, MD, Joseph H. Gorman, MD The Annals of Thoracic Surgery Volume 102, Issue 3, Pages 703-710 (September 2016) DOI: 10.1016/j.athoracsur.2016.05.087 Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 1 Schematic of the automated three-dimensional echocardiography (3DE) image segmentation and mitral valve modeling method. The Annals of Thoracic Surgery 2016 102, 703-710DOI: (10.1016/j.athoracsur.2016.05.087) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 2 (A) Atrial views of six normal mitral valves. (B) Atrial views of six myxomatous mitral valves with posterior leaflet defects. The Annals of Thoracic Surgery 2016 102, 703-710DOI: (10.1016/j.athoracsur.2016.05.087) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 3 Mitral valve with posterior leaflet prolapse (left) and normal morphology (right) are shown from (top row) atrial and (bottom row) medial viewpoints. The portion of the posterior leaflet above the posterior annular plane, whose bounds are indicated by the red square, is shown in red. The Annals of Thoracic Surgery 2016 102, 703-710DOI: (10.1016/j.athoracsur.2016.05.087) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 4 Mean ± SD of the annular height to commissural width ratio (AHCWR) plotted as a function of rotation position along the mitral annulus. The AHCWR curve for the myxomatous valves is shown in red; the curve for the normal valves is shown in blue. Statistically significant differences in regional AHCWR are indicated in gray. (AAoP = anterior aortic peak of annulus; ACM = anterior commissure; PCM = posterior commissure; SD = standard deviation.) The Annals of Thoracic Surgery 2016 102, 703-710DOI: (10.1016/j.athoracsur.2016.05.087) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 5 Mean models of a myxomatous mitral valve (left) and normal mitral valve (right) shown to scale (top row, atrial viewpoint; and bottom row, along the septolateral direction). Leaflet thickness is displayed in color. The Annals of Thoracic Surgery 2016 102, 703-710DOI: (10.1016/j.athoracsur.2016.05.087) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions

Fig 6 (Left) Septolateral cross-sections of the three-dimensional image volume showing segmentation of the posterior leaflet in green and anterior leaflet in red. (Center) Three-dimensional image-derived models of the mitral valve. (Right) Intraoperative atrial views of two valves with posterior leaflet prolapse. The anterolateral and posteromedial commissures are on the left and right, respectively. The top and bottom rows are examples of two different patients' valves. The Annals of Thoracic Surgery 2016 102, 703-710DOI: (10.1016/j.athoracsur.2016.05.087) Copyright © 2016 The Society of Thoracic Surgeons Terms and Conditions