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Evaluation of mitral chordae tendineae length using four-dimensional computed tomography
Takuya Mori1,2, Satoshi Matsushita3, Terumasa Morita1
1Department of Cardiovascular Surgery, Juntendo University Faculty of Medicine, Tokyo 113-8421, Japan.
World Journal of Cardiology
|May 31, 2024
Summary
Four-dimensional CT (4D-CT) accurately measures mitral chordae tendineae length (CL) and behavior during systole. This imaging technique aids in planning mitral valvuloplasty procedures using artificial chordae tendineae.
Area of Science:
- Cardiovascular Imaging
- Medical Engineering
- Cardiac Surgery
Background:
- Mitral regurgitation can be treated with mitral valvuloplasty using artificial chordae tendineae.
- Precise measurement of artificial chordae tendineae length (CL) is crucial but lacks objective indices.
- Four-dimensional x-ray micro-computed tomography (4D-CT) offers dynamic 3D evaluation for accurate CL measurement.
Purpose of the Study:
- To investigate the dynamic behavior and length of mitral chordae tendineae during systole using 4D-CT.
- To establish a method for accurate preoperative assessment of chordae tendineae length for surgical planning.
Main Methods:
- Eleven adults over 70 without mitral valve disease underwent 4D-CT with 20 cardiac phases.
- Mitral chordae tendineae (cA and cP) lengths were measured from early systole to early diastole.
- Correlation of maximum chordae tendineae lengths (cA (max), cP (max)) with body surface area (BSA) was evaluated.
Main Results:
- 4D-CT enabled measurement of mitral anterior leaflet chordae tendineae (cA and cP) in all subjects.
- Mean maximum lengths were cA (max) = 20.2 mm and cP (max) = 23.5 mm, with cP (max) being significantly longer.
- Chordae tendineae lengths varied during systole, with cP showing a plateau of elongation, and correlations with BSA were observed (r=0.60 for cA, r=0.78 for cP).
Conclusions:
- 4D-CT is a valuable tool for precise measurement of mitral chordae tendineae length and behavior.
- This technique supports improved surgical planning for mitral valvuloplasty.
- Dynamic assessment of chordae tendineae using 4D-CT enhances understanding of mitral valve function.
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