[Usefulness of intraoperative echocardiography for the management of mitral regurgitation]

Intraoperative transesophageal echocardiography is crucial in the management of patients with mitral regurgitation. In fact, a vast majority mitral insufficiencies may actually be repaired. This kind of surgery require an excellent definition of anatomic lesions and mechanisms of mitral regurgitation in order to optimize the result of the repair. In this field, intraoperative echocardiographic findings are complementary with anatomical findings for the surgeon. Before surgery, intraoperative echography help to describe all valvular lesions and mechanisms of the regurgitation. Three-dimensional echocardiography may be obtained using intraoperative echography and may be useful in mitral valve prolapse to better define the location and size of prolapse and to communicate informations to the surgeon. After repair, echographyallow the control of the result and also of right and left ventricular function. In case of major abnormality such as residual significant mitral regurgitation or important intra-ventricular obstruction, a second procedure may be required. The collaboration between the echographist and the surgeon is crucial to obtain the best results in mitral valve repair. Indications for intraoperative echocardiography are dependent on the experience of the surgeon and the complexity of mitral lesions to repair.