3D Transoesophageal Echocardiographic Assessment of the Mitral Valve

• Research type

  Research Study

• Full title

  3D Transoesophageal Echocardiographic Assessment of the Mitral Valve

• IRAS ID

  141416

• Contact name

  Prakash Punjabi

• Contact email

  p. punjabi@imperial.nhs.uk

• Research summary

  Current MV repair techniques include surgical restoration of leaflet coaptation and addressing mitral annular dilatation (reducing annular circumference in order to increase coaptation surface and reduce risk of recurrence). Previous studies have shown that such surgical manouvers alter geometry, shape and dynamics of mitral apparatus. Recent advancement in 3D echocardiography and introduction of routine perioperative TOE monitoring has provided an opportunity to assess anatomy and function of mitral apparatus. Concomitantly numerous parameters have been explored to assist the surgeon in selecting appropriate operative technique and optimize repair results. Such parameters, i.e., : intercommisural distance, intertrigonal distance, anterior mitral leaflet length, height and surface area, coaptation depth and coaptation distance between the commissures. These measurements are readily obtainable by TOE, and are accurate and reproducible.

  The aim of our study is to evaluate the anatomy of a normal mitral valve, obtain normal values of the parameters described above, find a correlation to BSA.#
  Also, in patients undergoing mitral reparative surgery, similar measurements will be undertaken both before + after intervention.

  To assess the anatomy of a normal mitral valve, 3D TOE will be performed in patients undergoing CABG +/- AVR, with standard intraoperative TOE for assesment of LV and valvular function.
  Also, other inpatients/outpatients undergoing TOE for other clinical indications, i.e. assessment of other heart valves, etc. known to have normal mitral valve.

  To assess incompetent and repaired mitral valves 3D TOE will be performed in patients undergoing surgical MV repair who receive TOE as part of standard intraoperative care.
  Only members of the research team will screen patients and make the initial approach to them.

• REC name

  London - Stanmore Research Ethics Committee

• REC reference

  14/LO/0361

• Date of REC Opinion

  14 Mar 2014

• REC opinion

  Favourable Opinion