Page 100 - Advanced echocardiography in characterization and management of patients with secondary mitral regurgitation

Chapter five. MV geometry: The COAPT Trial
tethering length (the white dashed line from the posterior papillary muscle to the contralateral mitral valve annulus). Panel C shows the apical 2-chamber view, demonstrating the posterior papillary muscle to the mitral valve annulus distance (the white dashed line from the posterior papillary muscle to the contralateral mitral valve annulus) and the anterior papillary muscle to the mitral valve annulus distance (the white dashed line from the anterior PM to the contralateral mitral valve annulus).
Table 1. Summary of mitral valve geometry measurements using two-dimensional transthoracic echocardiography.
Parameter
Anterior-posterior mitral annulus diameter
Intercommissural mitral annulus diameter
Anterior and posterior mitral valve leaflet length
Coaptation to septum distance
Tenting height
Tenting area
Anterior- and posterior papillary muscle to mitral valve annulus distance
Basal mitral anterior leaflet angle
Distal mitral anterior leaflet angle
Posterior mitral leaflet angle
Definition
The distance between the anterior point and posterior point of the mitral annulus
The distance from commissure to commissure of the mitral annulus
The length of the mitral valve leaflet measured from the hinge point of the leaflet to the leaflet tip
The distance between the coaptation point of the mitral valve leaflets and the septum at the hinge point of the aortic valve cusps
The distance between the coaptation point of the mitral valve leaflets and the mitral annular plane
The area enclosed by the mitral valve leaflets and the mitral annular plane
The distance between the PM tips to the contralateral mitral annulus, providing an estimation of PM displacement
The angle between the basal anterior leaflet and mitral annulus (traced from mitral annular plane to the bending point of the anterior mitral valve leaflet)
The angle between the anterior leaflet and mitral valve annulus (traced from mitral annular plane to the bending point of the anterior mitral valve leaflet)
The angle between the posterior leaflet and mitral valve annulus (traced from mitral annular plane to the tip of the posterior mitral valve leaflet)
TTE view
Parasternal long- axis
Apical 2-chamber view
Parasternal long- axis
Parasternal long- axis
Parasternal long- axis
Parasternal long- axis
Apical 2-chamber view (if not visible, measured on apical 4-chamber view)
Apical 4-chamber view
Apical 4-chamber view
Apical 4-chamber view
Timing on TTE
End-diastole End-diastole
Diastole, maximum extension of leaflets
Mid-systole
Mid-systole
Mid-systole Mid-systole
Mid-systole Mid-systole Mid-systole
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