Mitral annular disjunction was associated with a significantly shorter distance to the left circumflex coronary artery (3.2 mm vs. 4.9 mm).
Does multiplanar reconstruction of intraoperative TEE images identify differences in the distance between the mitral annulus and the left circumflex coronary artery in patients with versus without mitral annular disjunction?
Multiplanar reconstruction of intraoperative TEE demonstrates that the distance between the mitral annulus and the LCX is significantly shorter in patients with mitral annular disjunction, particularly near the anterolateral commissure.
Absolute Event Rate: 0% vs 0%
Abstract OBJECTIVES We aimed to describe the anatomical distance between the mitral annulus and the left circumflex coronary artery (LCX) using multiplanar reconstruction (MPR) of transoesophageal echocardiography (TEE) images and to investigate its association with mitral annular disjunction (MAD). METHODS A single-center retrospective cohort study included 54 patients who underwent mitral valve repair for mitral regurgitation between January 2020 and July 2021. We measured the distance between the mitral annulus and the LCX (ML distance) using MPR of intraoperative TEE images. As an exploratory analysis, we compared the ML distance between patients with MAD (group D: N = 11) and those without (group N: N = 43). RESULTS The LCX was closest to the mitral annulus at 70–90 degrees counterclockwise from the anteroposterior axis. No cases of LCX injury were observed. MAD was most frequently observed at P1, and all patients in group D had disjunction at P1. The minimum ML distance was significantly shorter in group D than in group N (3.2 1.1 mm in group D, and 4.9 2.1 mm in group N). Overall, the ML distance was shorter in group D than in group N, and was significantly shorter at 70–100 degrees. CONCLUSIONS MPR of intraoperative TEE images is a less invasive and useful tool to detect patients with a short ML distance. The area of the closest distance from the mitral annulus to the LCX is near the anterolateral commissure, especially in patients with MAD.
Kuroda et al. (Sat,) reported a other. Mitral annular disjunction was associated with a significantly shorter distance to the left circumflex coronary artery (3.2 mm vs. 4.9 mm).