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Echocardiographic visualization and quantification of mitral complex during mitral repair for severe functional mitral regurgitation  Kikuko Obase, MD,

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Presentation on theme: "Echocardiographic visualization and quantification of mitral complex during mitral repair for severe functional mitral regurgitation  Kikuko Obase, MD,"— Presentation transcript:

1 Echocardiographic visualization and quantification of mitral complex during mitral repair for severe functional mitral regurgitation  Kikuko Obase, MD, Ichiro Matsumaru, MD, Takashi Miura, MD, Kiyoyuki Eishi, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 154, Issue 4, Pages (October 2017) DOI: /j.jtcvs Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 The triple repair consisted of papillary muscle (PM) suspension, anterior leaflet augmentation, and annuloplasty. The pericardial patch for the augmentation of the anterior leaflet was designed to cover the whole annular plane. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 Postoperative long-axis view on transesophageal echocardiography visualized deep coaptation and sufficient opening of leaflets. Video of this view is in Video 1, along with postoperative transthoracic echocardiography with and without color Doppler mode. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

4 Figure 3 Preoperative (left) and postoperative (right) 3-dimensional models of the reconstructed mitral leaflet, the annulus, and the positions of the papillary muscle (PM) tips are shown. Multidirectional observations of these 3-dimensional images are available in Video 2 and Video 3. M, Medial; P, posterior; A, anterior; L, lateral. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

5 Figure 4 Volume-rendering image of transesophageal echocardiography with the transgastric approach allows us to visualize the postoperative submitral apparatus. The pairs of suture for papillary muscle (PM) suspension were clearly visualized (Video 4). The sutures were connected to each fibrous trigone, which can be plainly recognized in this image. The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

6 Preoperative and postoperative 3D reconstructed mitral leaflet, annulus, papillary tips.
The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

7 Video 1 Postoperative long-axis views by transesophageal echocardiography (left) and by transthoracic echocardiography with (right) and without (middle) color Doppler flow. Video available at: The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

8 Video 2 Multidirectional observation of 3-dimensional reconstructed preoperative mitral valve complex. L, Lateral; M, medial; P, posterior; AL, anterior papillary muscle tip; PM, posterior papillary muscle tip. Video available at: The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

9 Video 3 Multidirectional observation of 3D reconstructed postoperative mitral valve complex. A, Anterior; L, lateral; M, medial; AL, anterior papillary muscle tip; PM, posterior papillary muscle tip; P, posterior. Video available at: The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

10 Video 4 Volume-rendering image of postoperative mitral valve complex. PM, Papillary muscle. Video available at: The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2017 The American Association for Thoracic Surgery Terms and Conditions

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