3-dimensional transesophageal echocardiography showed excellent correlation with computed tomography for D-shaped mitral annulus area (11.3 vs 11.4; r=0.84, P<0.0001) with no systematic bias.
Observational (n=41)
Does 3-dimensional transesophageal echocardiography provide comparable D-shaped mitral annulus dimensions to computed tomography in patients with severe mitral regurgitation evaluated for transcatheter mitral valve implantation?
3D-TEE provides comparable D-shaped mitral annulus dimensions to cardiac CT, supporting its use as a complementary tool for sizing in transcatheter mitral valve implantation.
Effect estimate: r=0.84
Absolute Event Rate: 11.3% vs 11.4%
p-value: p=0.67
BACKGROUND: Previously, through the use of computed tomography (CT), it has been proposed that D-shaped versus saddle-shaped mitral annulus (MA) segmentation is more biomechanically appropriate to determine transcatheter mitral valve implantation size and eligibility. METHODS AND RESULTS: Forty-one patients with severe mitral regurgitation being considered for transcatheter mitral valve implantation who had undergone cardiac CT and 3-dimensional transesophageal echocardiography (3D-TEE) were retrospectively evaluated. A standardized segmentation protocol for the D-shaped MA was developed using Philips Q-Laboratory mitral valve quantification software. MA dimensions were compared using Spearman's rank correlation and Bland-Altman analysis. Inter- and intraobserver agreement was quantified by intraclass correlation coefficient and Bland-Altman analysis. Mean age was 77±14 years; 71% male (n=29); mitral regurgitation pathogenesis was functional in 54% (n=22) and myxomatous in 46% (n=19). Mean MA area and circumference by 3D-TEE and CT were 11.3±2.7 versus 11.4±3.0 (P=0.67) and 124.1±15.6 versus 123.9±15.5 (P=0.79), respectively, with excellent correlation between modalities (r=0.84 and r=0.86; P0.90 for all parameters. CONCLUSIONS: Similar to cardiac CT, 3D-TEE allows for D-shaped MA segmentation with no systematic difference in MA dimensions between modalities. This study supports the utilization of 3D-TEE as a complementary tool to CT assessment of the D-shaped MA to determine transcatheter mitral valve implantation size.
Mak et al. (Wed,) conducted a observational in severe mitral regurgitation (n=41). 3-dimensional transesophageal echocardiography (3D-TEE) vs. Computed tomography (CT) was evaluated on Mean mitral annulus area (r=0.84, p=0.67). 3-dimensional transesophageal echocardiography showed excellent correlation with computed tomography for D-shaped mitral annulus area (11.3 vs 11.4; r=0.84, P<0.0001) with no systematic bias.