The Mitral Coaptation to Ventricular Septal Space: Two and Three Dimensional Transesophageal Echocardiographic (TEE) Assessment

Abstract Objectives: To assess the dimensions and changes in the CSEPT space (between the ventricular septum and mitral coaptation point) before and after cardiopulmonary bypass, and to compare patients with and without aortic valve stenosis undergoing cardiac surgery. Design: Retrospective review of intraoperative transesophageal echocardiographic exams. Setting: Single Academic Medical Center. Participants: 91 elective cardiac surgical patients: 30 with aortic valve stenosis (AS) scheduled for aortic valve replacement (AVR) and 61 without AS (non-AS). Interventions: Two (2D) and three (3D) dimensional analysis of the CSEPT before and after cardiopulmonary bypass (CPB). Measurements and Main Results: Assessment of the CSEPT distances and areas were performed using 2D and 3D imaging pre- and post-CPB. 2D measures of CSEPT distances were performed using mid-esophageal (ME) 5 chamber (5C) and long-axis (LAX) windows. 3D measures were performed off-line using multiplanar reconstruction (MPR). The CSEPT space was smaller after CPB (p Conclusions: The CSEPT space is smaller after CPB and more so for patients with AS undergoing AVR. 2D CEPT distances vary when compared to 3D CSEPT distance. Further study using Doppler analysis will elucidate the added value of 3D assessment of the CSEPT space.