Objective: We sought to determine the feasibility and accuracy of the 3D transthoracic (3D-TTE)echocardiography compared with 2D transesophageal (2D-TEE) and 2D transthoracic(2D-TTE)echocardiography using surgical findings as gold standard.
Methods: Patients (pts) with moderate to severe MR referred for MV surgery underwent both preoperative TEE and 3DE studies. Findings of TEE and 3DE were compared those found at surgery, using the nomenclature Carpentier.
Results: A total of 93 pts were studied to localize mitral pathology and regurgitation defects. Findings include: normal leaflet motion (n=12), excessive motion of a MV leaflet (n=53) and restricted motion of an MV leaflet (n=28). As each MV has six sections, a total of 558 mitral sections were evaluated. Defect location agreement between the TEE and surgical findings was 91%, and between the 3DE and surgical finding was 95%. 3DE can describe the eccentrically directed regurgitant jet and multi-jets regurgitation, obtain qualitative analyses of MR severity. 3DE can accurately measure ERO, MV area, annular circumference and tenting volume. Mean ERO was (0.39±0.30 cm2) and annular circumference was (8.0±2.0 cm).
Conclusions: 3DE appears to provide similar and in some cases is a superior diagnostic non-invasive evaluation tool compared with TEE regarding the etiology and extent of MR, possibly obviating the need for TEE prior to MR surgery.