VALIDATION OF MITRAL VALVE ANNULUS DIMENSIONS MEASURED BY 2D TRANS-THORACIC ECHOCARDIOGRAPHY WITH GOLD STANDARD DIRECT INTRA-OPERATIVE MEASUREMENT

CONTEXT: Precise estimation of Mitral valve annulus dimensions preoperatively through Echocardiography is of paramount importance in replacement/repair surgeries. However a frequent disagreement was experienced between anticipated size of prosthetic valve based on echocardiography and actual valve size. This fact encouraged the authors to validate the measurements through echocardiography with gold-standard direct intra operative measurement. AIM: To compare the mitral valve anterior-posterior (short axis) and commissure -commissural (long axis) annulus dimensions estimated through 2D Trans-thoracic Echocardiography with Gold Standard direct Intra-operative Measurement. SETTING AND DESIGN: Hospital based prospective longitudinal study. MATERIALS AND METHODS: 67 participants suffering from Rheumatic Heart Disease (RHD) patients with severe mitral valve disease were underwent 2-dimensional trans- thoracic echocardiography preoperatively to determine mitral valve short and long axis. Direct measurements for the same were made intra-operatively at the diastolic arrested heart through left atriotomy. STATISTICAL ANALYSIS: Univariate analysis (t-test) for difference of mean, confidence interval with standard error estimation. RESULTS AND CONCLUSION: Mitral valve annulus axis measurements with or without consideration of Body Surface Area (BSA) were significantly overestimated by 2-D echocardiography judged against direct measurement. A mathematical model or correction index is proposed further to estimate the prosthesis size from these overvalued