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Left Ventricular Remodelling After Mitral Valve Reconstruction: A Prospective 3d Tee Study
Inna Kammerer, Armin Vomend, Falk-Udo Sack.
Department of Cardiac Surgery, Ludwigshafen, Germany.

Objective: The aim of this prospective study is the evaluation of the postoperative remodelling of the left ventricle (LV) in after mitral valve reconstruction (MVR) in patients with isolated mitral valve disease. Methods: Since 2011 49 patients were enrolled. In a prospective trial, LV geometry was assessed by the real-time 3-dimensional transoesophageal echocardiography (3D TEE) pre-, early and 12 months postoperatively. Of these, 38 (78%) were men, the mean age was 60 + 15 years. Minimal invasive operation technique (MIC) was done in more than 85% of MVR. Preliminary results: One patient died 4 months after MVR due to an aortic dissection Stanford A. The 1year freedom from reoperation or severe recurrent insufficiency was 92% (n=44). The mean ischemia time observed 73 + 20min, the mean hospital duration was 10 + 4days. The posterior leaflet correction with mean 34 + 2mm ring size was made in 81% of patients (n=40), in 17% (n=8) only ring without leaflet surgery and in 2% (n=1) anterior leaflet rectification. The 1year follow-up was done in 79% (n=33). The LV remodelling parameters in 3D TEE diagnostic observed incurred levels of pres-sures in hospital and 1year follow-up history (Table I). Conclusion: Measurements of ventricular geometry with the 3D transoesophageal echocardiography TEE proved to be important imaging tools in assessing reverse LV remodelling. There is a clear tendency for postoperative remodelling. Long term follow-up (1year) in a biger population will provide more information of the dynamics of this process.

Table I: 3D TEE parameters in pre-, early and 12 months postoperative clinical date (EF= ejection fr
n=49 meanEF preOP EF pod EF 12months podEDP preOPEDP pod EDP 12months podESP preOPESP podESP 12months pod
3D TEE59% + 9 57% + 10 51% + 1052mmHg + 9 53mmHg + 7 54mmHg + 736mmHg + 8 38mmHg + 8 37mmHg + 6
LVOT preOP LVOT pod LVOT 12months podLA preOP LA pod LA 12months pod
3D TEE0.86m/sec + 0.32 1.06m/sec + 0.39 0.81m/sec + 0.1746mm + 9 45mm + 7 46mm + 8

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