The Use of Real-time 2D and 3D TransesOphageal EchOcardiOgraphy in Mitral Valve Surgery

摘要

The requirements for transesophageal echocardiography(TEE)to aSSeSS the morphology and function of the mitral valve(MV)is largely dependant on the development and widespread use of techniques for surgical valve reconstruction．The feasibility of repair depends on the anatomic lesions of MV，underscoring the importance of accurately defining the functional anatomy of MV for clinical decision-making．Thus，there is a need for a reliable and reproducible method for the comprehensive assessment of MV pathomorphology．The MV apparatus consists of the mitral annulus，leaflets，chordae，and the papillary muscle-left ventricular(LV)wall complex．The mitral annulus serves as basal attachment for the mitral leaflets．The annulus is thicker over the one third of its anterior region where it merges with the fibrous intertrigonal membrane and supports the anterior MV leaflet(AML)．The remaining two thirds of the annulus，which lies more posteriorly from the trigones，is thinner and is therefore more susceptible to dilation，which mc~ases tension on the posterior mitral leaflet(PML)and may be responsible for the increased prevalence of observed disruption to the middle portion of the this leaflet．