Mitral valve morphology assessment: three-dimensional transesophageal echocardiography versus computed tomography

Shanks, Miriam, Delgado, Victoria, Ng, Arnold C. T., van der Kley, Frank, Schuijf, Joanne D., Boersma, Eric, van de Veire, Nico R. L., Nucifora, Gaetano, Bertini, Matteo, de Roos, Albert, Kroft, Lucia, Schalij, Martin J. and Bax, Jeroen J. (2010) Mitral valve morphology assessment: three-dimensional transesophageal echocardiography versus computed tomography. Annals of Thoracic Surgery, 90 6: 1922-1929. doi:10.1016/j.athoracsur.2010.06.116

Author Shanks, Miriam
Delgado, Victoria
Ng, Arnold C. T.
van der Kley, Frank
Schuijf, Joanne D.
Boersma, Eric
van de Veire, Nico R. L.
Nucifora, Gaetano
Bertini, Matteo
de Roos, Albert
Kroft, Lucia
Schalij, Martin J.
Bax, Jeroen J.
Title Mitral valve morphology assessment: three-dimensional transesophageal echocardiography versus computed tomography
Journal name Annals of Thoracic Surgery   Check publisher's open access policy
ISSN 0003-4975
Publication date 2010-11-01
Sub-type Article (original research)
DOI 10.1016/j.athoracsur.2010.06.116
Volume 90
Issue 6
Start page 1922
End page 1929
Total pages 8
Place of publication Philadelphia, PA, United States
Publisher Elsevier
Language eng
Formatted abstract
Background: Advances in the minimally invasive mitral valve repair techniques increase the demands on accurate and reliable morphologic assessment of the mitral valve using three-dimensional imaging modalities. The present study compared mitral valve geometry measurements obtained by three-dimensional transesophageal echocardiography (TEE) to those obtained with multidetector row computed tomography (MDCT) used as a standard reference.
Methods: Clinical preoperative MDCT and intraoperative three-dimensional TEE were performed in 43 patients (mean age 81.0 ± 7.7 years) considered for transcatheter valve implantation procedure. Various measurements of mitral valve geometry were obtained from three-dimensional TEE datasets using mitral valve quantification software, and compared with those obtained from MDCT images using multiplanar reformation planes.
Results: Moderate and severe mitral regurgitation was present in 48.9% of patients. There was good agreement in mitral valve geometry measurements between three-dimensional TEE and MDCT without significant overestimation or underestimation and tight 95% limits of agreement. For linear dimensions, angles and areas, the 95% limits of agreement were less than 1 cm, less than 15 degrees, and less than 2 cm2, respectively. In addition, the intraclass correlation coefficients were more than 0.8 for all parameters. Finally, the measurements were highly reproducible, with low intraobserver and interobserver variability (nonsignificant overestimation or underestimation and narrow 95% limits of agreement).
Conclusions: The present study demonstrates the accuracy and clinical feasibility of the assessment of the mitral valve geometry with three-dimensional TEE that is comparable to the MDCT measurements. Three-dimensional TEE and MDCT provide accurate and complementary information in the evaluation of patients with mitral valve disease. Its potential incremental clinical value in the field of transcatheter mitral repair procedures needs further assessment in the future studies.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: School of Medicine Publications
Centre for Advanced Imaging Publications
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 21 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 22 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Mon, 15 Apr 2013, 10:01:10 EST by Dr Chin Tse Arnold Ng on behalf of Centre for Advanced Imaging