Key result
Preoperative mitral diameters measured on TTE and CT scan correlated with actual mitral prosthetic size, with the highest correlation seen for mean TTE diameter (r = 0.702).
Why the study?
Annular rupture and patient-prosthetic mismatch remain problematic in minimally invasive mitral valve replacement, particularly in Asian populations, warranting a predictor model for prosthesis size.
Does preoperative measurement of mitral valve diameters using TTE and CT scan predict actual mitral prosthesis size in patients undergoing minimally invasive mitral valve replacement?
Observational (n=96)
No
Does preoperative measurement of mitral valve diameters using TTE and CT scan predict actual mitral prosthesis size in patients undergoing minimally invasive mitral valve replacement?
Effect estimate: r = 0.702
Preoperative TTE and CT scan measurements can reliably predict mitral prosthesis size, particularly for bioprostheses, which may help prevent patient-prosthesis mismatch and annular rupture.
TTE/CT mitral diameters correlate with prosthetic size; hypothesis-generating for preoperative planning, prospective validation required.
BACKGROUND: Minimally invasive mitral valve replacement has become popular across the world. However, annular rupture and patient - prosthetic mismatch (PPM) are still problematic, particularly in the Asian population. To avoid this, a predictor model could be beneficial. Our study aimed to assess the value of mitral valve diameters measured on TTE and CT scan on predicting the actual mitral prostheses. METHODS: From January 2018 to December 2019, a total number of 96 patients underwent minimally invasive mitral valve replacement. The association between imaging measurements and the outcome was checked by scatter plot and Pearson's correlation coefficient. Univariable linear regression was used to build the prediction model. RESULTS: The three strongest correlations for the whole population are the following features: Mean TTE diameter (0.702), mean diameter on CT lowest plane through the mitral annulus (0.679), and area-derived diameter on CT highest plane through the mitral annulus (0.665). The prosthetic size of the tissue valve group was more correlated to the calculated annulus diameters than that of the mechanical valve group. Tissue valve size predictor models based on these calculated diameters were 16.19 + 0.27 × d (r = 0.744), 12.74 + 0.44 × d (r = 0.756) and 12.79 + 0.38 × d (r = 0.730), respectively. CONCLUSION: Mitral prosthetic size could be predicted based on the mitral diameters measured on TTE and CT scan. The overall correlation coefficient varied from 0.665 (CT Scan) to 0.702 (TTE). These models performed better when applied to bioprosthesis.
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Vo et al. (2020) conducted an observational in Mitral valve disease requiring replacement (n=96). Preoperative mitral valve diameter measurement (TTE and CT scan) was evaluated on Correlation between preoperative mitral annulus diameters and actual prosthetic size (r = 0.702). Preoperative mitral diameters measured on TTE and CT scan correlated with actual mitral prosthetic size, with the highest correlation seen for mean TTE diameter (r = 0.702).
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