Utility of Multidetector Computed Tomographic Angiography as an Alternative to Transesophageal Echocardiogram for Preoperative Transcatheter Mitral Valve Repair Planning

Craig Basman; Caroline Ong; Tikal Kansara; Zain Kassam; Caleb Wutawunashe; Jennifer Conroy; Arber Kodra; Biana Trost; Priti Mehla; Luigi Pirelli; Jacob Scheinerman; Varinder P Singh; Chad A Kliger

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자료유형: 학술저널

저자정보: Craig Basman (Lenox Hill Hospital/Northwell Health) Caroline Ong (Lenox Hill Hospital/Northwell Health) Tikal Kansara (Lenox Hill Hospital/Northwell Health) Zain Kassam (Lenox Hill Hospital/Northwell Health) Caleb Wutawunashe (Lenox Hill Hospital/Northwell Health) Jennifer Conroy (Lenox Hill Hospital/Northwell Health) Arber Kodra (Lenox Hill Hospital/Northwell Health) Biana Trost (Lenox Hill Hospital/Northwell Health) Priti Mehla (Lenox Hill Hospital/Northwell Health) Luigi Pirelli (Lenox Hill Hospital/Northwell Health) Jacob Scheinerman (Lenox Hill Hospital/Northwell Health) Varinder P Singh (Lenox Hill Hospital/Northwell Health) Chad A Kliger (Lenox Hill Hospital/Northwell Health)

저널정보: 한국심초음파학회 Journal of Cardiovascular Imaging Journal of Cardiovascular Imaging 제31권 제1호

발행연도: 2023.1

수록면: 18 - 23 (6page)

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BACKGROUND: Three-dimensional (3D) transesophageal echocardiogram (TEE) is the gold standard for the diagnosis of degenerative mitral regurgitation (dMR) and preoperative planning for transcatheter mitral valve repair (TMVr). TEE is an invasive modality requiring anesthesia and esophageal intubation. The severe acute respiratory syndrome coronavirus 2 pandemic has limited the number of elective invasive procedures. Multi-detector computed tomographic angiography (MDCT) provides high-resolution images and 3D reconstructions to assess complex mitral anatomy. We hypothesized that MDCT would reveal similar information to TEE relevant to TMVr, thus deferring the need for a preoperative TEE in certain situations like during a pandemic. METHODS: We retrospectively analyzed data on patients who underwent or were evaluated for TMVr for dMR with preoperative MDCT and TEE between 2017 and 2019. Two TEE and 2 MDCT readers, blinded to patient outcome, analyzed: leaflet pathology (flail, degenerative, mixed), leaflet location, mitral valve area (MVA), flail width/gap, anterior-posterior (AP) and commissural diameters, posterior leaflet length, leaflet thickness, presence of mitral valve cleft and degree of mitral annular calcification (MAC). RESULTS: A total of 22 (out of 87) patients had preoperative MDCT. MDCT correctly identified the leaflet pathology in 77% (17/22), flail leaflet in 91% (10/11), MAC degree in 91% (10/11) and the dysfunctional leaflet location in 95% (21/22) of patients. There were no differences in the measurements for MVA, flail width, commissural or AP diameter, posterior leaflet length, and leaflet thickness. MDCT overestimated the measurements of flail gap. CONCLUSIONS: For preoperative TMVr planning, MDCT provided similar measurements to TEE in our study.

#Mitral valve #Multidetector computed tomography #Transesophageal echocardiography

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