Intraoperative Assessment of Perivalvular Mitral Regurgitation: Utility of Three-Dimensional Echocardiography

摘要

Conventional 2-dimensional (2D) transesophageal echocardiography (TEE) is widely used intraoperatively in mitral valve surgery during both valve repair and valve replacement procedures.3 The identification of prosthetic mitral valve dysfunction in the immediate post-cardiopulmonary bypass (CPB) period can provide useful information as to the need for immediate corrective surgery. Previous application of 3D TEE for the assessment of prosthetic valves in the immediate post-CPB period was hampered by the time necessary to acquire and reconstruct the 3D volume sets. With the advent of faster reconstructive software and hardware, intraoperative 3D echocardiography may provide additional information and improve spatial orientation and communication regarding prosthetic valve regurgitation.4 This case report describes a clinical scenario in which the use of 3D echocardiographic reconstruction and analysis during the post-CPB assessment facilitated identification and location of a perivalvular leak misidentified with 2D imaging.