Assessment of successful valve reconstruction by intraoperative transesophageal echocardiography (TEE)

In 17 patients (10 patients with mitral insufficiency, 5 patients with tricuspid regurgitation, 2 patients with mitral stenosis) the result of valve reconstruction was evaluated by intraoperative two-dimensional transesophageal contrast-echocardiography (TEE). Therefore, 1-2cc of an agitated contrast-medium (Gelifundol) were injected into the left or right ventricle. The result of reconstruction was assessed by the extent of regurgitant microbubbles into the left or right atrium. A successful valve repair could be demonstrated in 15 patients without or with only minimal regurgitation of contrast-fluid. In one patient residual severe mitral insufficiency after valve reconstruction could only be detected when valve function was examined by contrast-TEE in the beating heart. An intraoperative decision for valve replacement was made. In another patient, mild to moderate residual mitral incompetence was shown; no further surgical intervention was done. By TEE the function of reconstructed valves can be examined under physiological conditions in the beating heart. Surgeons can obtain additional intra-operatively information and certainty about the result of reconstruction and an early decision for valve replacement can be made if necessary.