Brazilian Journal of Anesthesiology
https://bjan-sba.org/journal/rba/article/doi/10.1016/j.bjane.2022.03.002
Brazilian Journal of Anesthesiology
Systematic Review

Intraoperative transesophageal echocardiography following mitral valve repair: a systematic review

Ecocardiografia transesofágica intraoperatória após plastia valvar mitral: uma revisão sistemática

Raffael Zamper, Agya Prempeh, Ivan Iglesias, Ashraf Fayad

Downloads: 0
Views: 594

Abstract

Objective
We aimed to examine the recent evidence and search for novel assessments on intraoperative TEE following mitral valve repair that can impact short and long-term outcomes.

Methods
The Ovid MEDLINE, PubMed, and EMBASE databases were searched from January 1, 2008, until January 27, 2021, for studies on patients with severe Mitral Valve Regurgitation (MR) undergoing Mitral Valve (MV) repair surgery with intraoperative Transesophageal Echocardiography (TEE) performed after the repair. Additional searches were conducted using Google search engine, Web of Science, and Cochrane Library.

Results
After reviewing 302 records, 8 retrospective and 22 prospective studies were included (n = 30). Due to clinical and methodological diversity, these studies are noncomparable and data were not amenable to quantitative synthesis.

Conclusion
Although technological advances allowed the objective assessment of geometric and dynamic alterations of the MV, the impact of the use of these technologies on short- or long-term outcomes was not studied. There is uncertainty and conflicting evidence on the ideal method and metrics to evaluate MV patency post-repair. Few isolated studies validated methods to assess coaptation surface and LV function post-repair.

Keywords

Intraoperative transesophageal echocardiography;  TEE;  Mitral valve;  Mitral valve repair;  Systematic review

Resumo

Objetivo: Nosso objetivo foi examinar as evidências recentes e buscar novas avaliações sobre a ETE intraoperatória após o reparo da valva mitral que podem impactar os resultados a curto e longo prazo. Métodos: As bases de dados Ovid MEDLINE, PubMed e EMBASE foram pesquisadas de 1º de janeiro de 2008 a 27 de janeiro de 2021, para estudos de pacientes com regurgitação mitral grave (RM) submetidos à cirurgia de reparo da valva mitral (VM) com ecocardiografia transesofágica intraoperatória (ETE) realizado após o reparo. Pesquisas adicionais foram realizadas usando o mecanismo de busca Google, Web of Science e Cochrane Library. Resultados: Após revisão de 302 registros, 8 estudos retrospectivos e 22 estudos prospectivos foram incluídos (n = 30). Devido à diversidade clínica e metodológica, esses estudos não são comparáveis e os dados não foram passíveis de síntese quantitativa. Conclusão: Embora os avanços tecnológicos tenham permitido a avaliação objetiva das alterações geométricas e dinâmicas da VM, não foi estudado o impacto do uso dessas tecnologias nos resultados a curto ou longo prazo. Há incerteza e evidências conflitantes sobre o método e as métricas ideais para avaliar a permeabilidade da VM após o reparo. Poucos estudos isolados validaram métodos para avaliar a superfície de coaptação e a função do VE pós-reparo.

Palavras-chave

Idade; Idoso; Transplante de fígado; Complicações pósoperatórias.

References

1 Carroll, D., Weerakkody, Y. Carpentier classification of mitral valve regurgitation. Reference article, Radiopaedia.org. https://doi.org/10.53347/rID-63316.

2 M Enriquez-Sarano, CW Akins, A. Vahanian Mitral regurgitation Lancet, 373 (2009), pp. 1382-1394

3 R Prakash, M Horsfall, A Markwick, et al. Prognostic impact of moderate or severe mitral regurgitation (MR) irrespective of concomitant comorbidities: a retrospective matched cohort study BMJ Open, 4 (2014), Article e004984

4 JS Gammie, S Sheng, BP Griffith, et al. Trends in mitral valve surgery in the United States: results from the Society of Thoracic Surgeons Adult Cardiac Surgery Database Ann Thorac Surg, 87 (2009), pp. 1431-1437 discussion 7-9

5 SK. Shernan Perioperative transesophageal echocardiographic evaluation of the native mitral valve Crit Care Med, 35 (8 Suppl) (2007), pp. S372-S383

6 DA Sidebotham, SJ Allen, IL Gerber, et al. Intraoperative transesophageal echocardiography for surgical repair of mitral regurgitation J Am Soc Echocardiogr, 27 (2014), pp. 345-366

7 TE David, J Ivanov, S Armstrong, et al. A comparison of outcomes of mitral valve repair for degenerative disease with posterior, anterior, and bileaflet prolapse J Thorac Cardiovasc Surg, 130 (2005), pp. 1242-1249

8 R Lorusso, M De Bonis, G De Cicco, et al. Mitral insufficiency and its different aetiologies: old and new insights for appropriate surgical indications and treatment J Cardiovasc Med (Hagerstown), 8 (2007), pp. 108-113

9 RM Suri, HV Schaff, JA Dearani, et al. Survival advantage and improved durability of mitral repair for leaflet prolapse subsets in the current era Ann Thorac Surg, 82 (2006), pp. 819-826

10 D Moher, A Liberati, J Tetzlaff, et al. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA Statement Open Med, 3 (2009), pp. e123-e130

11 JPT Higgins, J Thomas, J Chandler, et al. Cochrane Handbook for Systematic Reviews of Interventions (2nd ed.), John Wiley & Sons, Chichester (UK) (2019)

12 P Lancellotti, L Moura, LA Pierard, et al. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: mitral and tricuspid regurgitation (native valve disease) Eur J Echocardiogr, 11 (2010), pp. 307-332

13 RA Nishimura, CM Otto, RO Bonow, et al. 2014 AHA/ACC guideline for the management of patients with valvular heart disease: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines J Am Coll Cardiol, 63 (2014), pp. 2438-2488

14 Y Wang, CQ Gao, JL Wang, et al. The role of intraoperative transesophageal echocardiography in robotic mitral valve repair Echocardiography, 28 (2011), pp. 85-91

15 J Grewal, S Mankad, WK Freeman, et al. Real-time three-dimensional transesophageal echocardiography in the intraoperative assessment of mitral valve disease J Am Soc Echocardiogr, 22 (2009), pp. 34-41

16 F Mahmood, R. Matyal A quantitative approach to the intraoperative echocardiographic assessment of the mitral valve for repair Anesth Analg, 121 (2015), pp. 34-58

17 I. Iglesias Intraoperative TEE assessment during mitral valve repair for degenerative and ischemic mitral valve regurgitation Semin Cardiothorac Vasc Anesth, 11 (2007), pp. 301-305

18 SC. Banakal Intraoperative transesophageal echocardiographic assessment of the mitral valve repair Ann Card Anaesth, 13 (2010), pp. 79-84

19 A. Maslow Mitral valve repair: an echocardiographic review: Part 2 J Cardiothorac Vasc Anesth, 29 (2015), pp. 439-471

20 J Ender, S. Sgouropoulou Value of transesophageal echocardiography (TEE) guidance in minimally invasive mitral valve surgery Ann Cardiothorac Surg, 2 (2013), pp. 796-802

21 JL Reshmi, G Gopan, PK Varma, et al. Transesophageal Echocardiographic Assessment of the Repaired Mitral Valve: A Proposed Decision Pathway Seminars in Cardiothoracic and Vascular Anesthesia (2021) September

22 N Ma, ZA Li, X Meng, et al. Live three-dimensional transesophageal echocardiography in mitral valve surgery Chin Med J, 121 (2008), pp. 2037-2041

23 F Maffessanti, NA Marsan, G Tamborini, et al. Quantitative analysis of mitral valve apparatus in mitral valve prolapse before and after annuloplasty: a three-dimensional intraoperative transesophageal study J Am Soc Echocardiogr, 24 (2011), pp. 405-413

24 C Pan, XH Shu, Q Cao, et al. Role of real-time three-dimensional transesophageal echocardiography in mitral valve repair J Geriatr Cardiol, 5 (2008), pp. 137-141

25 L Tautz, L Walczak, J Georgii, et al. Combining position-based dynamics and gradient vector flow for 4D mitral valve segmentation in TEE sequences Int J Comput Assist Radiol Surg, 15 (2020), pp. 119-128

26 K Bartels, RH Thiele, B Phillips-Bute, et al. Dynamic indices of mitral valve function using perioperative three-dimensional transesophageal echocardiography J Cardiothorac Vasc Anesth, 28 (2014), pp. 18-24

27 J Grewal, R Suri, S Mankad, et al. Mitral annular dynamics in myxomatous valve disease: new insights with real-time 3-dimensional echocardiography Circulation, 121 (2010), pp. 1423-1431

28 F Mahmood, S Karthik, B Subramaniam, et al. Intraoperative application of geometric three-dimensional mitral valve assessment package: a feasibility study J Cardiothorac Vasc Anesth, 22 (2008), pp. 292-298

29 A Maslow, F Mahmood, A Poppas, et al. Three-dimensional echocardiographic assessment of the repaired mitral valve J Cardiothorac Vasc Anesth, 28 (2014), pp. 11-17

30 M Vergnat, MM Levack, AS Jassar, et al. The influence of saddle-shaped annuloplasty on leaflet curvature in patients with ischaemic mitral regurgitation Eur J Cardiothorac Surg, 42 (2012), pp. 493-499

31 M Vergnat, BM Jackson, AT Cheung, et al. Saddle-shape annuloplasty increases mitral leaflet coaptation after repair for flail posterior leaflet Ann Thorac Surg, 92 (2011), pp. 797-803

32 S Ben Zekry, S Jain, SK Alexander, et al. Novel parameters of global and regional mitral annulus geometry in man: comparison between normals and organic mitral regurgitation, before and after mitral valve repair Eur Heart J Cardiovasc Imaging, 17 (2016), pp. 447-457

33 F Veronesi, EG Caiani, L Sugeng, et al. Effect of mitral valve repair on mitral-aortic coupling: a real-time three-dimensional transesophageal echocardiography study J Am Soc Echocardiogr, 25 (2012), pp. 524-531

34 S Manabe, H Kasegawa, T Fukui, et al. Morphological analysis of systolic anterior motion after mitral valve repair Interact Cardiovasc Thorac Surg, 15 (2012), pp. 235-239

35 C Rosendal, MD Hien, T Bruckner, et al. Left ventricular outflow tract: intraoperative measurement and changes caused by mitral valve surgery J Am Soc Echocardiogr, 25 (2012), pp. 166-172

36 W Ma, W Ye, J Zhang, et al. Impact of different annuloplasty rings on geometry of the mitral annulus with fibroelastic deficiency: the significance of aorto-mitral angle Int J Cardiovasc Imaging, 34 (2018), pp. 1707-1713

37 F Mahmood, B Subramaniam, JH Gorman 3rd, et al. Three-dimensional echocardiographic assessment of changes in mitral valve geometry after valve repair Ann Thorac Surg, 88 (2009), pp. 1838-1844

38 F Mahmood, JH Gorman 3rd, B Subramaniam, et al. Changes in mitral valve annular geometry after repair: saddle-shaped versus flat annuloplasty rings Ann Thorac Surg, 90 (2010), pp. 1212-1220

39 H Nishi, K Toda, S Miyagawa, et al. Annular dynamics after mitral valve repair with different prosthetic rings: a real-time three-dimensional transesophageal echocardiography study Surg Today, 46 (2016), pp. 1083-1090

40 K Owais, H Kim, KR Khabbaz, et al. In-vivo analysis of selectively flexible mitral annuloplasty rings using three-dimensional echocardiography Ann Thorac Surg, 97 (2014), pp. 2005-2010

41 J Grapsa, I Zimbarra Cabrita, G Jakaj, et al. Strain balance of papillary muscles as a prerequisite for successful mitral valve repair in patients with mitral valve prolapse due to fibroelastic deficiency Eur Heart J Cardiovasc Imaging, 16 (2015), pp. 53-61

42 A Maslow, A Gemignani, A Singh, et al. Intraoperative assessment of mitral valve area after mitral valve repair: comparison of different methods J Cardiothorac Vasc Anesth, 25 (2011), pp. 221-228

43 A. Nicoara, N. Skubas, N. Ad, A. Finley, R.T. Hahn, F. Mahmood, et al. Guidelines for the use of transesophageal echocardiography to assist with surgical decision-making in the operating room: a surgery-based approach: from the american society of echocardiography in collaboration with the Society of Cardiovascular Anesthesiologists and the Society of Thoracic Surgeons J Am Soc Echocardiogr, 33 (2020), pp. 692-734

44 M. Essandoh Intraoperative echocardiographic assessment of mitral valve area after degenerative mitral valve repair: a call for guidelines or recommendations J Cardiothorac Vasc Anesth, 30 (2016), pp. 1364-1368

45 WJ Vernick, EA Ochroch, J Horak, et al. Validation study of Doppler-derived transmitral valve gradients compared to near simultaneously obtained directly measured catheter gradients immediately after mitral valve repair surgery J Card Surg, 28 (2013), pp. 329-335

46 AK Riegel, R Busch, S Segal, et al. Evaluation of transmitral pressure gradients in the intraoperative echocardiographic diagnosis of mitral stenosis after mitral valve repair PLoS ONE, 6 (11) (2011), p. e26559 [Electronic Resource]

47 WS Kang, JW Choi, JE Kang, et al. Determination of mitral valve area with echocardiography, using intra-operative 3-dimensional versus intra- & post-operative pressure half-time technique in mitral valve repair surgery J Cardiothorac Surg, 8 (2013), p. 98

48 S Karamnov, N Burbano-Vera, DC Shook, et al. A novel 3-dimensional approach for the echocardiographic evaluation of mitral valve area after repair for degenerative disease Anesth Analg, 130 (2020), pp. 300-306

49 M Padala, SN Powell, LR Croft, et al. Mitral valve hemodynamics after repair of acute posterior leaflet prolapse: quadrangular resection versus triangular resection versus neochordoplasty J Thorac Cardiovasc Surg, 138 (2009), pp. 309-315

50 AM Gillinov, DM Cosgrove, EH Blackstone, et al. Durability of mitral valve repair for degenerative disease J Thorac Cardiovasc Surg, 116 (1998), pp. 734-743

51 DG Greenhouse, SL Dellis, CF Schwartz, et al. Regional changes in coaptation geometry after reduction annuloplasty for functional mitral regurgitation Ann Thorac Surg, 93 (2012), pp. 1876-1880

52 JJ Bax, J Braun, ST Somer, et al. Restrictive annuloplasty and coronary revascularization in ischemic mitral regurgitation results in reverse left ventricular remodeling Circulation, 110 (11 Suppl 1) (2004) II103-8

53 DH Adams, R Rosenhek, V. Falk Degenerative mitral valve regurgitation: best practice revolution Eur Heart J, 31 (2010), pp. 1958-1966

54 D Wei, J Han, H Zhang, et al. The correlation between the coaptation height of mitral valve and mitral regurgitation after mitral valve repair J Cardiothorac Surg, 12 (2017), p. 120

55 Y Guo, Y He, Y Zhang, et al. Assessment of the mitral valve coaptation zone with 2D and 3D transesophageal echocardiography before and after mitral valve repair J Thorac Dis, 10 (2018), pp. 283-290

56 N Mabrouk-Zerguini, P Leger, S Aubert, et al. Tei index to assess perioperative left ventricular systolic function in patients undergoing mitral valve repair Br J Anaesth, 101 (2008), pp. 479-485

57 J Ender, M Selbach, MA Borger, et al. Echocardiographic identification of iatrogenic injury of the circumflex artery during minimally invasive mitral valve repair Ann Thorac Surg, 89 (2010), pp. 1866-1872

626fdd34a9539518c60bede3 rba Articles
Links & Downloads

Braz J Anesthesiol

Share this page
Page Sections