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Visualization Of Aortic Valve Fenestration By Three Dimensional Transesophageal Echocardiography For Aortic Valve Repair
Keitaro Mahara, Mitsuhiko Ota, Kanako Kishiki, Toshihiro Fukui, Shuichiro Takanashi.
Sakakibara Heart Institute, Tokyo, Japan.

OBJECTIVE: Aortic valve repair requires a tailored surgical approach determined by the leaflet and aortic root characteristics. Fenestration of aortic valve is not an uncommon malformation, but sometimes cause aortic valve regurgitation. We thought to determine Three-dimensional (3D) transesophageal echocardiography(TEE) improves the identification of aortic valve fenestration that requires patch closure for aortic valve repair. METHODS: We investigated consecutive 61 patients who underwent aortic valve plasty for aortic valve regurgitation in our institution from January 2012 to December 2013. Pre-operative 3D TEE was conducted within 3 months before surgery. RESULTS: 9 patients had aortic valve fenestration that requires autologous pericardial patch closure. 7 of 9 patients was diagnosed as aortic valve regurgitation due to fenestration by pre- operative 3D TEE. CONCLUSIONS: 3D TEE could visualize aortic valve fenestration by careful observation of commissures. 3DTEE is essential in the operative assessment of aortic valve regurgitation because accurate determination of origin, lesion localization, and mechanisms is required to determine the surgical techniques.

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