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Computed tomography angiography for imaging results of neochordal mitral valve repair
INTRODUCTION: Degenerative mitral regurgitation is currently the most frequent indication for mitral valve repair. AIM: To visualize and assess the mid-term results of mitral valve repair with neochordae implantation, using computed tomography angiography (CTA) imaging. MATERIAL AND METHODS: The CTA...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Termedia Publishing House
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5519832/ https://www.ncbi.nlm.nih.gov/pubmed/28747938 http://dx.doi.org/10.5114/kitp.2017.68736 |
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author | Zwoliński, Radosław Marcinkiewicz, Anna Szymczyk, Konrad Drożdż, Jarosław Jaszewski, Ryszard Jegier, Bogdan |
author_facet | Zwoliński, Radosław Marcinkiewicz, Anna Szymczyk, Konrad Drożdż, Jarosław Jaszewski, Ryszard Jegier, Bogdan |
author_sort | Zwoliński, Radosław |
collection | PubMed |
description | INTRODUCTION: Degenerative mitral regurgitation is currently the most frequent indication for mitral valve repair. AIM: To visualize and assess the mid-term results of mitral valve repair with neochordae implantation, using computed tomography angiography (CTA) imaging. MATERIAL AND METHODS: The CTA with ECG gating and without modulation was applied in 10 patients to assess the results of a mitral valve sparing procedure. The results of 3 patients are presented. The patients were operated on for severe symptomatic degenerative mitral regurgitation, defined according to a modified Carpentier’s functional classification. RESULTS: Neochordal repair, by placing expanded polytetrafluoroethylene sutures between the leading edge of the prolapsing segment and the corresponding papillary muscle, was conducted. From 1 to 3 double Gore-Tex loops were used. Leaflet clefts, if present, were sutured. All repairs included mitral valve ring annuloplasty. The CTA was performed at 20–24 months after the surgery. Long-axis views, reconstructed during mid-systole, seemed to be the most valuable. Good quality cardiac images, precisely presenting the mitral valve complex with its constituents, were obtained in the case of patients without obesity, with a relatively small anterior-posterior thorax dimension, with sinus, slow heart rhythm and quite good left ventricle contractility. The evaluation of the mitral valve included presence of calcifications, fibrosis or thickening, chordal insertion and coaptation points, and papillary muscle locations. Primary and secondary native chordae tendineae and artificial chordae were visualized. CONCLUSIONS: Contrast material-enhanced ECG-gated CTA applied after mitral valve repair with Gore-Tex neochordae allows one to obtain satisfactory mitral valve images, especially during mid-systole, and evaluate mid-term results of the surgery in chosen patients. |
format | Online Article Text |
id | pubmed-5519832 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Termedia Publishing House |
record_format | MEDLINE/PubMed |
spelling | pubmed-55198322017-07-26 Computed tomography angiography for imaging results of neochordal mitral valve repair Zwoliński, Radosław Marcinkiewicz, Anna Szymczyk, Konrad Drożdż, Jarosław Jaszewski, Ryszard Jegier, Bogdan Kardiochir Torakochirurgia Pol Original Paper INTRODUCTION: Degenerative mitral regurgitation is currently the most frequent indication for mitral valve repair. AIM: To visualize and assess the mid-term results of mitral valve repair with neochordae implantation, using computed tomography angiography (CTA) imaging. MATERIAL AND METHODS: The CTA with ECG gating and without modulation was applied in 10 patients to assess the results of a mitral valve sparing procedure. The results of 3 patients are presented. The patients were operated on for severe symptomatic degenerative mitral regurgitation, defined according to a modified Carpentier’s functional classification. RESULTS: Neochordal repair, by placing expanded polytetrafluoroethylene sutures between the leading edge of the prolapsing segment and the corresponding papillary muscle, was conducted. From 1 to 3 double Gore-Tex loops were used. Leaflet clefts, if present, were sutured. All repairs included mitral valve ring annuloplasty. The CTA was performed at 20–24 months after the surgery. Long-axis views, reconstructed during mid-systole, seemed to be the most valuable. Good quality cardiac images, precisely presenting the mitral valve complex with its constituents, were obtained in the case of patients without obesity, with a relatively small anterior-posterior thorax dimension, with sinus, slow heart rhythm and quite good left ventricle contractility. The evaluation of the mitral valve included presence of calcifications, fibrosis or thickening, chordal insertion and coaptation points, and papillary muscle locations. Primary and secondary native chordae tendineae and artificial chordae were visualized. CONCLUSIONS: Contrast material-enhanced ECG-gated CTA applied after mitral valve repair with Gore-Tex neochordae allows one to obtain satisfactory mitral valve images, especially during mid-systole, and evaluate mid-term results of the surgery in chosen patients. Termedia Publishing House 2017-06-30 2017-06 /pmc/articles/PMC5519832/ /pubmed/28747938 http://dx.doi.org/10.5114/kitp.2017.68736 Text en Copyright: © 2017 Polish Society of Cardiothoracic Surgeons (Polskie Towarzystwo KardioTorakochirurgów) and the editors of the Polish Journal of Cardio-Thoracic Surgery (Kardiochirurgia i Torakochirurgia Polska) http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license. |
spellingShingle | Original Paper Zwoliński, Radosław Marcinkiewicz, Anna Szymczyk, Konrad Drożdż, Jarosław Jaszewski, Ryszard Jegier, Bogdan Computed tomography angiography for imaging results of neochordal mitral valve repair |
title | Computed tomography angiography for imaging results of neochordal mitral valve repair |
title_full | Computed tomography angiography for imaging results of neochordal mitral valve repair |
title_fullStr | Computed tomography angiography for imaging results of neochordal mitral valve repair |
title_full_unstemmed | Computed tomography angiography for imaging results of neochordal mitral valve repair |
title_short | Computed tomography angiography for imaging results of neochordal mitral valve repair |
title_sort | computed tomography angiography for imaging results of neochordal mitral valve repair |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5519832/ https://www.ncbi.nlm.nih.gov/pubmed/28747938 http://dx.doi.org/10.5114/kitp.2017.68736 |
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