Three-Dimensional Echocardiography Compared with cardiac Computed Tomography to assess Mitral Annulus Size before surgical mitral valve replacement

Mohammed, Wael Atteia; Khalaf, Hani Abdelshafook; Abdelfattah, Mohamed; Fouad, Tamer Ahmed; Khairy, Ahmed M.

doi:https://doi.org/10.21608/aimj.2025.446592

Three-Dimensional Echocardiography Compared with cardiac Computed Tomography to assess Mitral Annulus Size before surgical mitral valve replacement

Document Type : Original Article

Authors

¹ Cardiology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt.

² Radiology Department, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

https://doi.org/10.21608/aimj.2025.446592

Abstract

Background: Although Echocardiography is still considered the gold standard imaging to evaluate the function of the mitral valve, multidetector computed tomography (MDCT) is the gold standard for mitral annulus evaluation. transoesophageal Echocardiography also used for assessment of geometry of mitral valve apparatus with added benefit of three dimensions measurements of the mitral valve.
Aim: To correlate three-dimensional Echocardiography and computed tomography in sizing the mitral valve annulus before surgical mitral valve replacement.
Methods: This study included 42 patients (53 ± 8 years old, 79% female) who are eligible for MVR underwent 3D TEE and MDCT. Assessment of mitral annulus, including mitral annular area (MAA), perimeter, anteroposterior (AP) and antrolateral-postromedial (AL-PM) diameters, were measured using 3D TEE and MDCT, and were correlated with intraoperative measurements.
Results: Compared to MDCT, MAA, perimeter, AL-PM, and AP diameters measured on 3D TEE were larger (10.6 ± 1.25 vs. 9.9 ± 1.09 cm2 for MAA; 120.3 ± 6.04 vs. 116 ± 6.03 mm for perimeter, 36 ± 2.95vs. 31.83 ± 3.24 mm for AL-PM distance, and 30.05 ± 3.05 vs. 26 ± 2.97 mm for AP distance, all p < 0.001). There was a positive correlation between mitral annular measurements by 3DTEE and MDCT, and these measurements correlated well with measurements of the prosthetic valve size.
Conclusion: This study showed good correlation between 3D-TEE and MDCT in evaluating mitral valve annulus before mitral valve replacement, although 3D-TEE provided larger measurements compared with MDCT.

Keywords