Interdisciplinary cardiovascular and thoracic surgery · 2026
Measurement of the Distance between the Mitral Annulus and the Left Circumflex Coronary Artery Using Multiplanar Reconstruction of Intraoperative Transoesophageal Echocardiography Images.
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Kuroda Yuki, Soga Yoshiharu, Matsuo Takehiko, Tsumaru Shinichi, Hakamada Keisuke, Wada Yuki, Kitagata Yuta, Imada Ryo, Marui Akira, Ohno Nobuhisa
Аннотация
OBJECTIVES: We aimed to describe the anatomical distance between the mitral annulus and the left circumflex coronary artery (LCX) using multiplanar reconstruction (MPR) of transoesophageal echocardiography (TEE) images and to investigate its association with mitral annular disjunction (MAD).
METHODS: A single-centre retrospective cohort study included 54 patients who underwent mitral valve repair for mitral regurgitation between January 2020 and July 2021. We measured the distance between the mitral annulus and the LCX (ML distance) using MPR of intraoperative TEE images. As an exploratory analysis, we compared the ML distance between patients with MAD (group D: N = 11) and those without (group N: N = 43).
RESULTS: The LCX was closest to the mitral annulus at 70-90 degrees counterclockwise from the anteroposterior axis. No cases of LCX injury were observed. MAD was most frequently observed at P1, and all patients in group D had disjunction at P1. The minimum ML distance was significantly shorter in group D than in group N (3.2 [1.1] mm in group D, and 4.9 [2.1] mm in group N). Overall, the ML distance was shorter in group D than in group N, and was significantly shorter at 70-100 degrees.
CONCLUSIONS: MPR of intraoperative TEE images is a less invasive and useful tool to detect patients with a short ML distance. The area of the closest distance from the mitral annulus to the LCX is near the anterolateral commissure, especially in patients with MAD.
METHODS: A single-centre retrospective cohort study included 54 patients who underwent mitral valve repair for mitral regurgitation between January 2020 and July 2021. We measured the distance between the mitral annulus and the LCX (ML distance) using MPR of intraoperative TEE images. As an exploratory analysis, we compared the ML distance between patients with MAD (group D: N = 11) and those without (group N: N = 43).
RESULTS: The LCX was closest to the mitral annulus at 70-90 degrees counterclockwise from the anteroposterior axis. No cases of LCX injury were observed. MAD was most frequently observed at P1, and all patients in group D had disjunction at P1. The minimum ML distance was significantly shorter in group D than in group N (3.2 [1.1] mm in group D, and 4.9 [2.1] mm in group N). Overall, the ML distance was shorter in group D than in group N, and was significantly shorter at 70-100 degrees.
CONCLUSIONS: MPR of intraoperative TEE images is a less invasive and useful tool to detect patients with a short ML distance. The area of the closest distance from the mitral annulus to the LCX is near the anterolateral commissure, especially in patients with MAD.