[Predictors Of Success In Mitral Valve Repair On Patients With Regurgitation Using 3d And Toe Technique]

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TABLE OF CONTENTS

1.0HYPOTHESIS1

2.0AIM1

3.0OBJECTIVES2

4.0METHODOLOGY2

4.1STUDY DESIGN2

5.0INTRODUCTIONS2

5.1MITRAL VALVE ANATOMY AND MORPHOLOGY2

5.1.1 Mitral Valve Anatomy5

5.1.2 Mitral Valve MorphologY5

5.2MINIMALLY INVASIVE MITRAL VALVE REPAIR5

5.2.1Challenges Posed By Modern Methods Of Mitral Valve ReconstructiON7

5.3ECHOCARDIOGRAPHIC ASSESSMENT9

5.4CAUSES AND MECHANISM OF MITRAL VALVE REGURGITATION13

5.5MITRAL VALVE REPLACEMENT19

5.6POSSIBLE REPAIR TECHNIQUES21

5.6.1 The Sor And The Regurgitant VolUME25

5.6.2 Ballooning Versus Prolapse ("ProlAPSE")26

5.6.3 Dystrophic Versus Im BaRLOW27

5.6.4 After Valve RepaiR27

5.6.5 Repair Of The Anterior Valve ProlaPSE28

5.6.6 Repair Of Commissural Valve ProlaPSE29

5.6.7 Treatment Of A Mitral Valve RestricTION30

5.6.8 MItral AnnuloplasTY31

5.6.9 Minimally Invasive ApproacH31

6.0MITRAL VALVE ASSESSMENT31

6.1 The Assessment of Mitral Valve by 3D and TOE imaging31

6.1.1 Assessment of Mitral Valve by 3D31

6.1.2 Assessment of Mitral Valve by TOE Imaging34

6.2 Mitral Valve Quantification programme (MVQ)38

REFERENCES41

Predictors Of Success In Mitral Valve Repair On Patients With Regurgitation Using 3d And Toe Technique

Hypothesis

In patients with Mitral Valve Regurgitation (MVR), the insufficient leaflet closure of Mitral valve causes the LV dysfunction and geometric alteration of the valve apparatus.

The repair of Mitral valve is a useful procedure for reducing the severity of regurgitation as well as improving the left ventricular function and valve geometry. It will also reduce the ejection fraction of the left ventricle (LV). It depends on the severity of the regurgitation of the valve. The repair methods are safer compared to replacement in increasing the mortality and reparability of the valve.

A real time 3D TOE technique performed for all pre and post-operative patients. The 3D TOE and Doppler ultrasound examination are significant tools to measure the severity of the mitral valve disease and analysis of lesion part of the valve as well as helping to identify the annular size of the valve using the MVQ application.

Aim

The aim of this project is to predict the success of surgical repair procedures on patients with Mitral valve regurgitation who have admitted to Hammersmith Hospital for possible surgical repair.

It is a perspective study assessing the potential changes to the MV leaflet geometric and MV annulus size as well as left ventricle functioning in post- operative patients.

Objectives

The current trend to achieve endoscopic mitral valve repair did not show any real superiority in terms of morbidity and mortality, length of hospitalization. The only benefit to date has established aesthetic desire especially in young women. It should, however, that the level of demand in terms of plastic surgery is the same as a tummy by sternotomy, the techniques used plasty can provide the same immediate and especially long-term than those described so far conventional surgery.

Methodology

Study Design

Inclusion Criteria for this project are as follows:

All male or female patients

Symptomatic and asymptomatic patients

Full TOE 3D examination on MV for all selected study group

Control group with normal MV function

Patients with MV regurgitation (moderate +3 to severe +4)

Introductions

Mitral valve Anatomy And Morphology

Andreas Vesalius (1514-1564) was known as the founder of modern human anatomy and according to Walmsley, it was Andreas who introduced a term “mitral”, the valve that prevents backflow of the blood to the left atrium during process ...