The three-dimensional geometric relationship between the mitral valvar annulus and the coronary arteries as seen from the perspective of the cardiac surgeon using cardiac computed tomography

European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery
Noa GhersinJonathan Lessick

Abstract

Mitral annuloplasty involves sewing a prosthetic ring to the mitral annulus. This involves a risk of damaging the surrounding structures in the left atrioventricular (AV) groove, particularly the left circumflex artery, which may be inadvertently sutured, causing an arterial occlusion. We have used cardiac computed tomography (CT) scans to study the three-dimensional relationship between the mitral valvar annulus and the neighbouring coronary arteries in the AV groove, and to map the distance between the arteries and the annulus. We examined cardiac CT scans of two groups of patient: 40 normal subjects, and 30 patients with left ventricular dysfunction and/or mitral regurgitation. The hinge line of the mitral valve, as well as the location of the coronary arteries within the left AV groove, was manually marked on a workstation and three-dimensional coordinates saved in digital format. Dedicated software was developed to calculate the plane of the mitral annulus, and the smallest distance between each point on the annulus and each of the left circumflex and right coronary arteries, called local minima. The global minimum for each heart is defined as the minimum of all local minima. The global minimum for the left circumflex aver...Continue Reading

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Citations

Oct 6, 2015·The Annals of Thoracic Surgery·Matteo PettinariRobert Dion
Dec 9, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Jessica MaoMarmar Vaseghi
Dec 10, 2014·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Robert H Anderson
Oct 12, 2016·The Journal of Thoracic and Cardiovascular Surgery·Juan A Crestanello
May 16, 2017·The International Journal of Cardiovascular Imaging·Carmine BevilacquaJoerg Ender
Nov 21, 2019·EuroIntervention : Journal of EuroPCR in Collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology·Ricarda HinzpeterHatem Alkadhi
May 25, 2016·Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions·Samir R KapadiaE Murat Tuzcu
Oct 22, 2020·The Thoracic and Cardiovascular Surgeon·Bálint FábiánTamás Ruttkay
Oct 16, 2021·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Noriaki KishimotoToshihiko Shibata

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