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Analysis of circumflex artery anatomy by real time 3D transesophageal echocardiography compared to cardiac computed

Carmine Bevilacqua1, Sarah Eibel2, Borek Foldyna3

  • 1Department of Anesthesiology and Intensive Care Medicine, Heart Center Leipzig, Struempellstr. 39, 04289, Leipzig, Germany. carmine.bevilacqua@helios-kliniken.de.

The International Journal of Cardiovascular Imaging
|May 15, 2017
PubMed

Insights

Real-time 3D transesophageal echocardiography (RT3D TEE) accurately measures circumflex artery (Cx) distances to the mitral annulus. This imaging technique shows strong correlation with MDCT, aiding in preventing iatrogenic injury during mitral valve repair.

Area of Science:

  • Cardiovascular Imaging
  • Surgical Anatomy
  • Medical Technology

Background:

  • Iatrogenic injury to the circumflex artery (Cx) is a rare but serious complication during mitral valve repair due to its proximity to the mitral annulus.
  • Accurate pre-operative assessment of the Cx artery's spatial relationship to the mitral valve is crucial for surgical planning and complication avoidance.

Purpose of the Study:

  • To compare measurements of the circumflex artery (Cx) using real-time three-dimensional transesophageal echocardiography (RT3D TEE) and multidetector computed tomography (MDCT).
  • To evaluate the correlation between RT3D TEE and MDCT in assessing Cx artery diameter and its distances to the mitral valve annulus.

Main Methods:

  • Retrospective analysis of preoperative RT3D TEE and MDCT datasets from 25 patients who underwent minimally invasive mitral valve surgery.
  • Measurement of Cx artery diameter and its horizontal and vertical distances from the center to the mitral valve annulus using both imaging modalities.

Main Results:

  • A strong correlation was observed between RT3D TEE and MDCT for horizontal and vertical Cx distances to the mitral annulus.
  • No significant correlation was found between the two imaging techniques for Cx artery diameter measurements.

Conclusions:

  • RT3D TEE is a reliable method for measuring the horizontal and vertical distances of the Cx artery to the mitral annulus.
  • RT3D TEE measurements correlate well with MDCT, supporting its use in pre-operative planning to mitigate risks associated with mitral valve repair.

Keywords:
Circumflex arteryIntraoperative 3D imagingMDCTMitral valve repairRT3D echocardiographyTEE

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