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. 2013 Nov;2(6):796-802.
doi: 10.3978/j.issn.2225-319X.2013.10.09.

Value of transesophageal echocardiography (TEE) guidance in minimally invasive mitral valve surgery

Jörg Ender  1 , Sophia Sgouropoulou  1
Affiliations

Value of transesophageal echocardiography (TEE) guidance in minimally invasive mitral valve surgery

Jörg Ender et al. Ann Cardiothorac Surg. 2013 Nov.

Abstract

The role of intraoperative transesophageal echocardiography (TEE) has increased tremendously since its first use in 1979. Today intraoperative TEE is a class I indication for surgical mitral valve reconstruction for evaluation of mitral valve pathology, graduation of mitral regurgitation and detection of potential risk factors as well as post-repair assessment. Real-time three-dimensional TEE offers anatomical visualization of the mitral valve apparatus, fundamental for virtual surgical planning of proper annuloplasty ring size. As minimally invasive and even off-pump techniques for mitral valve repair become more popular, image guidance by intraoperative TEE will play an essential role.

Keywords: Intraoperative transesophageal echocardiography (TEE); image guidance; minimally invasive; mitral valve repair; real time three dimensional TEE (RT 3D TEE).

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Figures

Figure 1
Figure 1
Visualization of the individual segments of the mitral valve in the standard views: Transgastric two chamber (A), basal short axis view (B), midesophageal-4 chamber (C), mitral commissural (D), 2 chamber (E), and long axis (F) views.
Figure 2
Figure 2
Visualization of the individual segments of the mitral valve in real-time 3D “surgical view”.
Figure 3
Figure 3
Pulmonary vein doppler flow: normal (A), mild (B), moderate (C), and severe (D) mitral regurgitation.
Figure 4
Figure 4
(A) Guide-wire for the femoral venous cannula coming from the inferior vena cava and going into the superior vena cava; (B) Position of the venous cannula in the superior vena cava.
Figure 5
Figure 5
(A) Guide-wire for the jugular venous cannula coming from the superior vena cava and going into the right atrium; (B) Positive bubble test in the right atrium with bubbles coming from the superior vena cava.
Figure 6
Figure 6
Arrow indicates echo-dense bubbles in the left ventricle.
Figure 7
Figure 7
3D multiple plane reconstruction of a patient with distortion of the circumflex artery (Cx). With arrows indicating the ringsuture responsible for the distortion in sagittal (A), coronal (B), and transverse plane (C). The crossing of the different planes allows identification of this specific ringsuture in 3D (D).
See this image and copyright information in PMC

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