Correlation of 2-Dimensional and 3-Dimensional Echocardiographic Analysis to Surgical Measurements of the Tricuspid Valve Annular Diameter
This study sought to determine if 3-dimensional (3D) echocardiography would more closely correspond to direct surgical measurements of the maximal tricuspid valve (TV) annular diameter than 2-dimensional (2D) measurements. Prospective study. The cardiothoracic operating rooms (ORs) at Mount Sinai Me...
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Published in | Journal of cardiothoracic and vascular anesthesia Vol. 33; no. 1; pp. 137 - 145 |
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Main Authors | , , , , , , |
Format | Journal Article |
Language | English |
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Elsevier Inc
01.01.2019
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Abstract | This study sought to determine if 3-dimensional (3D) echocardiography would more closely correspond to direct surgical measurements of the maximal tricuspid valve (TV) annular diameter than 2-dimensional (2D) measurements.
Prospective study.
The cardiothoracic operating rooms (ORs) at Mount Sinai Medical Center in New York, NY.
Fifty-nine patients over 18 years of age underwent elective mitral valve surgery for severe mitral regurgitation from 2014 to 2015.
None.
Two-dimensional and 3D data sets and surgical TV annular dimensions were measured. Bland-Altman analysis was conducted and absolute differences were compared using paired t tests and the McNemar test.
The observed mean difference between the 2D measurements by transgastric right ventricular diastolic view and the surgical measurements was 0.21 cm (standard deviation [SD] = 0.36 cm); the mean difference between the 3D measurements and surgical measures was -0.03 cm (SD = 0.19 cm). The McNemar test showed that the rate of highly successful measurements, defined as those within 0.2 cm of the true surgical score, using the 3D technique (66%) was significantly better than the rate of highly successful measurements using the 2D technique (25%), p< 0.01, 2-sided.
Three-dimensional imaging and measurement of the TV annular diameter is feasible in the OR setting. The superiority of the 3D measurements versus 2D measurements allows for greater precision and accuracy and may guide better intraoperative surgical decision-making. |
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AbstractList | This study sought to determine if 3-dimensional (3D) echocardiography would more closely correspond to direct surgical measurements of the maximal tricuspid valve (TV) annular diameter than 2-dimensional (2D) measurements.
Prospective study.
The cardiothoracic operating rooms (ORs) at Mount Sinai Medical Center in New York, NY.
Fifty-nine patients over 18 years of age underwent elective mitral valve surgery for severe mitral regurgitation from 2014 to 2015.
None.
Two-dimensional and 3D data sets and surgical TV annular dimensions were measured. Bland-Altman analysis was conducted and absolute differences were compared using paired t tests and the McNemar test. The observed mean difference between the 2D measurements by transgastric right ventricular diastolic view and the surgical measurements was 0.21 cm (standard deviation [SD] = 0.36 cm); the mean difference between the 3D measurements and surgical measures was -0.03 cm (SD = 0.19 cm). The McNemar test showed that the rate of highly successful measurements, defined as those within 0.2 cm of the true surgical score, using the 3D technique (66%) was significantly better than the rate of highly successful measurements using the 2D technique (25%), p< 0.01, 2-sided.
Three-dimensional imaging and measurement of the TV annular diameter is feasible in the OR setting. The superiority of the 3D measurements versus 2D measurements allows for greater precision and accuracy and may guide better intraoperative surgical decision-making. OBJECTIVEThis study sought to determine if 3-dimensional (3D) echocardiography would more closely correspond to direct surgical measurements of the maximal tricuspid valve (TV) annular diameter than 2-dimensional (2D) measurements.DESIGNProspective study.SETTINGThe cardiothoracic operating rooms (ORs) at Mount Sinai Medical Center in New York, NY.PARTICIPANTSFifty-nine patients over 18 years of age underwent elective mitral valve surgery for severe mitral regurgitation from 2014 to 2015.INTERVENTIONSNone.MEASUREMENTS AND MAIN RESULTSTwo-dimensional and 3D data sets and surgical TV annular dimensions were measured. Bland-Altman analysis was conducted and absolute differences were compared using paired t tests and the McNemar test. The observed mean difference between the 2D measurements by transgastric right ventricular diastolic view and the surgical measurements was 0.21 cm (standard deviation [SD] = 0.36 cm); the mean difference between the 3D measurements and surgical measures was -0.03 cm (SD = 0.19 cm). The McNemar test showed that the rate of highly successful measurements, defined as those within 0.2 cm of the true surgical score, using the 3D technique (66%) was significantly better than the rate of highly successful measurements using the 2D technique (25%), p< 0.01, 2-sided.CONCLUSIONThree-dimensional imaging and measurement of the TV annular diameter is feasible in the OR setting. The superiority of the 3D measurements versus 2D measurements allows for greater precision and accuracy and may guide better intraoperative surgical decision-making. This study sought to determine if 3-dimensional (3D) echocardiography would more closely correspond to direct surgical measurements of the maximal tricuspid valve (TV) annular diameter than 2-dimensional (2D) measurements. Prospective study. The cardiothoracic operating rooms (ORs) at Mount Sinai Medical Center in New York, NY. Fifty-nine patients over 18 years of age underwent elective mitral valve surgery for severe mitral regurgitation from 2014 to 2015. None. Two-dimensional and 3D data sets and surgical TV annular dimensions were measured. Bland-Altman analysis was conducted and absolute differences were compared using paired t tests and the McNemar test. The observed mean difference between the 2D measurements by transgastric right ventricular diastolic view and the surgical measurements was 0.21 cm (standard deviation [SD] = 0.36 cm); the mean difference between the 3D measurements and surgical measures was -0.03 cm (SD = 0.19 cm). The McNemar test showed that the rate of highly successful measurements, defined as those within 0.2 cm of the true surgical score, using the 3D technique (66%) was significantly better than the rate of highly successful measurements using the 2D technique (25%), p< 0.01, 2-sided. Three-dimensional imaging and measurement of the TV annular diameter is feasible in the OR setting. The superiority of the 3D measurements versus 2D measurements allows for greater precision and accuracy and may guide better intraoperative surgical decision-making. |
Author | Bhatt, Himani V. Adams, David H. Fischer, Gregory W. El-Eshmawi, Ahmed Patel, Pritul R. Amir, Yasmin Spivack, John |
Author_xml | – sequence: 1 givenname: Himani V. orcidid: 0000-0002-8201-7476 surname: Bhatt fullname: Bhatt, Himani V. email: himani.bhatt@mountsinai.org organization: Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY – sequence: 2 givenname: John surname: Spivack fullname: Spivack, John organization: Department of Health Population Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY – sequence: 3 givenname: Pritul R. surname: Patel fullname: Patel, Pritul R. organization: Department of Anesthesiology, David Geffen School of Medicine at UCLA, Los Angeles, CA – sequence: 4 givenname: Ahmed surname: El-Eshmawi fullname: El-Eshmawi, Ahmed organization: Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY – sequence: 5 givenname: Yasmin surname: Amir fullname: Amir, Yasmin organization: Department of Anesthesiology, Icahn School of Medicine at Mount Sinai, New York, NY – sequence: 6 givenname: David H. surname: Adams fullname: Adams, David H. organization: Department of Cardiovascular Surgery, Icahn School of Medicine at Mount Sinai, New York, NY – sequence: 7 givenname: Gregory W. surname: Fischer fullname: Fischer, Gregory W. organization: Department of Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30072271$$D View this record in MEDLINE/PubMed |
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CitedBy_id | crossref_primary_10_1053_j_jvca_2021_02_067 crossref_primary_10_1007_s10554_021_02188_1 crossref_primary_10_1093_ehjci_jeaa058 crossref_primary_10_1053_j_jvca_2019_08_015 crossref_primary_10_1530_ERP_20_0033 |
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Keywords | heart valve repair 2D and 3D echo tricuspid valve echocardiography |
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SubjectTerms | 2D and 3D echo echocardiography heart valve repair tricuspid valve |
Title | Correlation of 2-Dimensional and 3-Dimensional Echocardiographic Analysis to Surgical Measurements of the Tricuspid Valve Annular Diameter |
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