Intraoperative TEE Assessment During Mitral Valve Repair for Degenerative and Ischemic Mitral Valve Regurgitation

Abstract

Intraoperative assessment of the mitral valve (MV) in patients undergoing repair for MV regurgitation is a valuable support for the cardiac surgical team; results can be favored by adequate assessment tailored to the main condition affecting the MV. This article will review current available data for assessment of the MV in degenerative and ischemic mitral regurgitation.

Intraoperative transesophageal echocardiography following mitral valve repair: a systematic review

“…These studies also demonstrate excellent correlation between TEE and surgical findings in both simple 14 and complex pathologies, 15 providing a structured comprehensive approach on how to perform a post-CPB exam that addresses separation from CPB, MV assessment (competency, patency and restoration of leaflet coaptation), Left Ventricular (LV) global and regional function, Left Ventricular Outflow Tract (LVOT) assessment for MV systolic anterior motion, and presence of new aortic insufficiency. 6 , 16 , 17 , 18 , 19 , 20 , 21 …”

“…New LV lateral wall regional motion abnormality following repair should raise suspicion of injury to the circumflex artery. 6 , 15 , 16 , 17 , 18 Ender et al proposed and validated a method to interrogate the circumflex artery with Color Flow Doppler (CFD) and Pulse Wave Doppler (PWD) at its proximal, intermediate, and distal segments, helpful to diagnose decreased flow or occlusion. 57 …”

Disección coronaria tras canulación directa de los ostiums coronarios

“…Así, para concluir, la disección coronaria en relación con la canulación directa de los ostiums coronarios es una complicación intraoperatoria muy infrecuente, que puede ser detectada mediante visualización directa en algunos casos, cambios electrocardiográficos y evaluación ecocardiográfica 4,5 . El bypass aortocoronario parece ser la mejor opción para resolver esta complicación, incluso si se acompa ña de insuficiencia mitral isquémica.…”

Ischemic mitral regurgitation

“…As a result, phenylephrine may be used to reflect normal hemodynamic conditions more accurately [44].…”