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16 - Mitral valve repair

from Section 2 - Practical issues in transesophageal echocardiography

Published online by Cambridge University Press:  10 May 2010

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Summary

Transesophageal echocardiography (TEE) has emerged as a valuable tool in mitral valve repair, with a role both in surgical decision making and in improving patient outcomes. The anterior part of the mitral annulus has a fibrous structure which is part of the aortic valve and the two trigones. In ischemic mitral regurgitation, a basal anteroposterior annulus diameter greater than 35 mm has a similar negative predictive value, and stress testing is unnecessary. The feasibility of mitral valve repair depends on valve function and morphology. Mitral stenosis is a rare consequence of edge-to-edge techniques. Annular avulsion can occur due to debridement of annular calcification. Wall motion abnormalities in the circumflex coronary artery territory can be a consequence of coronary interruption during annuloplasty. Intraoperative TEE can demonstrate functional valve anatomy and help to elucidate the mechanism of valve dysfunction.
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Publisher: Cambridge University Press
Print publication year: 2010

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