TEE Measurements
Pre-procedural TEE was performed using Epiq CVx system with an X8-2t Live 3D transducer (Philips Medical System, Andover, MA). The mitral valve was imaged and evaluated by conventional 2D with multiplane acquisition, color, and spectral Doppler imaging as well as by 3D TEE. Mitral valve morphology, MVA at end diastole, coaptation depth and length, flail width, flail gap, posterior mitral leaflet length, and AP and commissural diameters were assessed and measured using 2D and 3D images with multiplanar reconstruction using Q-Lab Software (Philips). Presence and location of mitral leaflet clefts were evaluated using 3D imaging with color Doppler. Presence and severity of MAC was assessed qualitatively. Discrepancies in assessment of valvular morphology and measurements were resolved by consensus.
Figure 2: Image A shows Flail Gap measured on MDCT, and Image B reveals similar measurements on TEE.
Figure 3: Mitral valve area (MVA) measured on multiplanar reconstruction on TEE compared to MVA measured on MDCT.
Figure 4: Posterior leaflet measurement on TEE vs MDCT