ArticleJournal of cardiothoracic surgery2017
Computer-based comparison of different methods for selecting mitral annuloplasty ring size.
Article in Journal of cardiothoracic surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Impact of the discrepancy between predicted and actual ring size on the outcomes of mitral valve repair using the loop technique.JTCVS open · 2025Article
- Mitral valvuloplasty using real-time three-dimensional transesophageal echocardiography.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2024Article
- Comparison of flexible, open with semi-rigid, closed annuloplasty-rings for mitral valve repair.Journal of cardiothoracic surgery · 2021Article
- User-dependent variability in mitral valve segmentation and its impact on CFD-computed hemodynamic parameters.International journal of computer assisted radiology and surgery · 2019Article
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6 authors.
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Abstract
backgroundRing sizing for mitral valve annuloplasty is conventionally done intraoperatively using specific 'sizer' instruments, which are placed onto the valve tissue. This approach is barely reproducible since different sizing strategies have been established among surgeons. The goal of this study is to virtually apply different sizing methods on the basis of pre-repair echocardiography to find out basic differences between sizing strategies.
methodsIn three-dimensional echocardiographs of 43 patients, the mitral annulus and the contour of the anterior mitral leaflet were segmented using MITK Mitralyzer software. Similarly, three-dimensional virtual models of Carpentier-Edwards Physio II annuloplasty rings and their corresponding sizers were interactively generated from computer tomography images. For each patient, the matching annuloplasty ring was selected repeatedly according to popular sizing strategies, such as the height of anterior mitral leaflet, the intercommissural distance and the surface area of anterior mitral leaflet. The areas of the selected rings were considered as the neo-surface area of the mitral annulus after implantation.
resultsThe sizing of the mitral valve according to the height of anterior mitral leaflet (mean ring size = 29.9 ± 3.90), intercommissural distance (mean ring size = 37.5 ± 1.92) or surface area of anterior mitral leaflet (mean ring size = 32.7 ± 3.3) led to significantly different measurements (p ≤ 0.01). In contrary to intercommissural distance, height and surface area of the anterior mitral leaflet exhibited significant variations between the patients (p ≤ 0.01). The sizing according to the height of anterior mitral leaflet led to the maximal reduction of the mitral annulus surface area followed by the sizing according to the surface area of anterior mitral leaflet and finally by the intercommissural distance.
conclusionsThis novel comprehensive computer-based analysis reveals that the surveyed sizing methods led to the selection of significantly different annuloplasty rings and therefore underscore the ambiguity of routinely applied annuloplasty sizing strategies.
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