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Published on: February 11, 2022
Mitral commissural prolapse
Eva D Papadimitraki1, Alexandros Patrianakos1, Antonios Pitsis2
1Department of Cardiology, University Hospital of Herakleion, Voutes, Crete, Greece.
Insights
Mitral commissural prolapse, a challenge in diagnosis and repair, often requires advanced 3D imaging. This condition increases the risk of reoperation after mitral valve repair surgery.
Area of Science:
- Cardiology
- Cardiac Surgery
- Echocardiography
Background:
- Mitral commissural prolapse presents diagnostic and management challenges, potentially leading to reoperation after mitral valve repair.
- Accurate identification of the prolapsing segment is difficult with standard 2D echocardiography.
Purpose of the Study:
- To analyze the characteristics of mitral commissural disease.
- To focus on 2D and 3D echocardiographic findings in commissural disease.
- To briefly comment on surgical correction techniques for commissural prolapse.
Main Methods:
- Review and analysis of echocardiographic findings (2D and 3D).
- Focus on diagnostic capabilities of different imaging modalities.
- Discussion of surgical techniques for commissural prolapse repair.
Main Results:
- Transthoracic 2D echocardiography often fails to accurately identify the prolapsing segment.
- Transesophageal 3D imaging is crucial for correct diagnosis and surgical planning.
- Various surgical techniques show good results in repairing commissural prolapse.
Conclusions:
- Mitral commissural prolapse requires advanced imaging for accurate diagnosis.
- 3D transesophageal echocardiography is essential for surgical planning.
- Effective surgical repair techniques are available for commissural prolapse.
Abstract:
Mitral commissural prolapse or flail, either isolated or combined with more extensive degenerative valve disease, imposes several challenges both on its diagnosis and management while being a risk factor for valve reoperation after mitral valve repair. Accurate identification of the prolapsing segment is often not feasible with transthoracic 2D echocardiography, with transesophageal 3D imaging then required for correct diagnosis and surgical planning. Various surgical techniques employed alone or in combination have yielded good results in the repair of commissural prolapse. Herein, we analyze the specific characteristics of commissural disease focusing our attention on 2D and 3D echocardiographic findings and we briefly comment on techniques employed for surgical correction of the disease.
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