2007 Fiscal Year Final Research Report Summary
Three-dimensional Echocardiographic Imaging of Mitral Valve Morphology : Clinical Impact on Mitral Valve Repair Surgery
| Project/Area Number |
18591568
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Thoracic surgery
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| Research Institution | Kawasaki Medical School |
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Principal Investigator |
TANEMOTO Kazuo Kawasaki Medical School, the Medical Department, Professor (90330547)
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| Co-Investigator(Kenkyū-buntansha) |
YOSHIDA Kiyoshi Kawasaki Medical School, the Medical Department, Professor (60322583)
HAMANAKA Sohei Kawasaki Medical School, the Medical Department, Lecturer (50351911)
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| Project Period (FY) |
2006 – 2007
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| Keywords | Mitral Regurgitation / Mitral Valve Plasty / Three-Dimensional / Ultrasoundcardiograohy |
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| Research Abstract |
Annuloplasty is currently a common surgical strategy for ischemic/functional MR, even if MR often persists after annuloplasty. Recently, new surgical strategies have been expected to reduce chronic persistent ischemic MR after annuloplasty. However, in the clinical setting, the degree of geometric changes of the mitral leaflets and annulus has previously assessed in a single slice of the mitral valve component by 2-D echocardiography, in spite of the unique configuration of the curved mitral valve and saddle-shaped mitral annulus. Hence, 2-D imaging plane that is currently used for the measurement of tenting length (coaptation length) or tenting area in the clinical studies may miss the maximum tethering site. Besides, present surgical approaches have been developed based on the beneficial result from animal experiments ignoring the various 3-D geometric deformities in each patient in the clinical setting. Precise and comprehensive understanding of the 3-D geometric change of the whole
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mitral leaflets and annulus is needed for successful valve repair in the clinical setting. We have developed a original software system which can provide 3-D geometry of the mitral leaflets and annulus, clarify the maximum tenting site of the mitral leaflet, and quantify the degree of mitral valve tenting and annular deformity in humans. It will be helpful for surgeon to know the precise mechanisms of the ischemic MR and to make a proper decision for the surgical strategy in each individual.
In the present project, we made an original software system to create 3D images of the mitral valve complex, and examine the clinical utility of the 3D assessment. In clinical and experimental studies, we demonstrated that the new volumetric parameters measured by 3D echocardiography was useful as preoperative evaluation in mitral valve repair surgery. 3D mitral valve tenting volume could be a predictor of recurrent heart failure after surgery, in patients with functional mitral regurgitation, which requires complicated surgical techniques. Less
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