Intraoperative Application of Geometric Three-Dimensional Mitral Valve Assessment Package: A Feasibility Study

Objective: To study the feasibility of using 3-dimensional (3D) echocardiography in the operating room for mitral valve repair or replacement surgery. To perform geometric analysis of the mitral valve before and after repair.Design: Prospective observational study.Setting: Academic, tertiary care hospital.Participants: Consecutive patients scheduled for mitral valve surgery.Interventions: Intraoperative reconstruction of 3D images of the mitral valve.Results: One hundred and two patients had 3D analysis of their mitral valve. Successful image reconstruction was performed in 93 patients—8 patients had arrhythmias or a dilated mitral valve annulus resulting in significant artifacts. Time from acquisition to reconstruction and analysis was less than 5 minutes. Surgeon identification of mitral valve anatomy was 100% accurate.Conclusions: The study confirms the feasibility of performing intraoperative 3D reconstruction of the mitral valve. This data can be used for confirmation and communication of 2-dimensional data to the surgeons by obtaining a surgical view of the mitral valve. The incorporation of color-flow Doppler into these 3D images helps in identification of the commissural or perivalvular location of regurgitant orifice. With improvements in the processing power of the current generation of echocardiography equipment, it is possible to quickly acquire, reconstruct, and manipulate images to help with timely diagnosis and surgical planning.