Size of mitral regurgitant orifice is defined by the area of prolapse: 3-D echo quantification

Christian S. Breburda*, Brian P. Griffin, James D. Thomas

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Previously we validated the direct measurement of the regurgitant orifice area (ROA) using 3-D echo for the assessment of the severity of mitral regurgitation, in comparison with the flow convergence method, but the relationship between prolapse geometry and ROA is unknown. Method: To test the hypothesis that the 3-D extent of prolapse might predict ROA and thus the severity of mitral regurgitation, we reconstructed the mitral valve using 3D echo (30 rotational acquisitions, TomTec, HP 2500) with a multiplane transesophageal probe in 14 pts undergoing mitral valve repair (age 59 ± 11 yrs, 9 M) The area of prolapse was directly planimetered in 3D echo from a left atrial view and the volume of prolapse was manually traced with paraplane echo (1 mm slices), these were compared to the directly planimetered ROA. Results: All pts had prolapse of the posterior leaflet. 12 pts had a flail portion. 3D echo reconstruction was accomplished in all 14 pts. Maximal ROA by 3D echo correlated significantly with area of prolapse with r = 0.58, p < 0.04, SEE 0.35 with the regression line equation of y = 0.07x + 0.4. Mean maximal ROA was 0.78 ± 0.4 cm2 and maximal area of prolapse was 4.87 ± 3 cm2 Maximal volume of prolapse was 48 ± 3.7 ml and did not correlate with ROA. Prolapse with a small volume extending mainly along the leaflet edge let to a large ROA. Conclusion: Severity of MR as defined by maximal size of ROA is predicted by maximal area but not volume of prolapse using direct planimetry by 3D echo.

Original languageEnglish (US)
Number of pages1
JournalJournal of the American Society of Echocardiography
Volume10
Issue number4
StatePublished - Dec 1 1997

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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