Mitral prosthetic size predictor in minimally invasive mitral valve replacement

• Published in: Journal of cardiothoracic surgery 2020-06, Vol.15 (1), p.1-147, Article 147
• Main Authors: Vo, Anh T, Nguyen, Nguyen T. H, Le, Khoi M, Vuong, Nguyen L, Nguyen, Trang T. T, Vu, Thanh T, Hoang, Sy V, Nguyen, Dinh H
• Format: Article
• Language: English
• Subjects: Annular rupture; Annuli; Cardiac computed tomography; CAT scans; Computed tomography; Correlation coefficient; Correlation coefficients; Diameters; Disease; Heart valves; Intensive care; Medical imaging; Minimally invasive approach; Mitral valve; Mortality; Patients; Pharmacy; Population; Prediction models; Prostheses; Prostheses and implants; Prosthetic size predictor; Prosthetics; Regression analysis; Software; Thoracic surgery; Transthoracic echocardiography
• ISSN: 1749-8090; 1749-8090
• DOI: 10.1186/s13019-020-01197-w

Background Minimally invasive mitral valve replacement has become popular across the world. However, annular rupture and patient - prosthetic mismatch (PPM) are still problematic, particularly in the Asian population. To avoid this, a predictor model could be beneficial. Our study aimed to assess the value of mitral valve diameters measured on TTE and CT scan on predicting the actual mitral prostheses. Methods From January 2018 to December 2019, a total number of 96 patients underwent minimally invasive mitral valve replacement. The association between imaging measurements and the outcome was checked by scatter plot and Pearson's correlation coefficient. Univariable linear regression was used to build the prediction model. Results The three strongest correlations for the whole population are the following features: Mean TTE diameter (0.702), mean diameter on CT lowest plane through the mitral annulus (0.679), and area-derived diameter on CT highest plane through the mitral annulus (0.665). The prosthetic size of the tissue valve group was more correlated to the calculated annulus diameters than that of the mechanical valve group. Tissue valve size predictor models based on these calculated diameters were 16.19 + 0.27 x d (r = 0.744), 12.74 + 0.44 x d (r = 0.756) and 12.79 + 0.38 x d (r = 0.730), respectively. Conclusion Mitral prosthetic size could be predicted based on the mitral diameters measured on TTE and CT scan. The overall correlation coefficient varied from 0.665 (CT Scan) to 0.702 (TTE). These models performed better when applied to bioprosthesis. Keywords: Prosthetic size predictor, Annular rupture, Minimally invasive approach, Cardiac computed tomography, Transthoracic echocardiography