Intraoperative Transesophageal Echocardiography for Surgical Repair of Mitral Regurgitation

• Published in: Journal of the American Society of Echocardiography Vol. 27; no. 4; pp. 345 - 366
• Main Authors: Sidebotham, David Andrew, MB ChB, FANZCA, Allen, Sara Jane, MB ChB, FANZCA, FCICM, Gerber, Ivor L., MB ChB, MD, FRACP, FACC, Fayers, Trevor, MB ChB, FRACS, FCS(SA)
• Format: Journal Article
• Language: English
• Published: United States Mosby, Inc 01.04.2014
• Subjects: Cardiac surgery; Cardiovascular; Echocardiography, Transesophageal - methods; Humans; Image Enhancement - methods; Intraoperative; Mitral Valve Annuloplasty - methods; Mitral Valve Insufficiency - diagnostic imaging; Mitral Valve Insufficiency - surgery; Mitral valve repair; Monitoring, Intraoperative - methods; Patient Selection; Surgery, Computer-Assisted - methods; TEE; Transesophageal echocardiography; Transesophageal echocardiography; Nyquist limit; Two-dimensional; LVEF; Cardiac surgery; VCW; LVOT; Tricuspid regurgitation; PVR; Systolic anterior motion; Proximal isovelocity surface area; 2D; Left ventricular ejection fraction; Anteroposterior; Vena contracta area; Left ventricular outflow tract; Pulmonary vascular resistance; EROA; Effective regurgitant orifice area; Mitral valve; PISA; FED; MR; Intraoperative; MV; Mitral valve repair; Fibroelastic deficiency; FMR; AP; Cardiopulmonary bypass; Functional mitral regurgitation; 3D; CPB; Three-dimensional; TEE; VCA; Mitral regurgitation; Vena contracta width; NL; SAM; TR
• ISSN: 0894-7317; 1097-6795
• DOI: 10.1016/j.echo.2014.01.005

Surgical repair of the mitral valve is being increasingly performed to treat severe mitral regurgitation. Transesophageal echocardiography is an essential tool for assessing valvular function and guiding surgical decision making during the perioperative period. A careful and systematic transesophageal echocardiographic examination is necessary to ensure that appropriate information is obtained and that the correct diagnoses are obtained before and after repair. The purpose of this article is to provide a practical guide for perioperative echocardiographers caring for patients undergoing surgical repair of mitral regurgitation. A guide to performing a systematic transesophageal echocardiographic examination of the mitral valve is provided, along with an approach to prerepair and postrepair assessment. Additionally, the anatomy and function of normal and regurgitant mitral valves are reviewed.