Study Population
After IRB approval and waiver of consent, two cardiac anesthesiologists reviewed and graded pre-bypass TEE images from patients who underwent elective mitral valve repair for MV prolapse due to degenerative mitral valve disease at Mount Sinai Medical Center from June 2009 through December 2011. Patients who had prolapse due to other etiologies (e.g. rheumatic disease or endocarditis) were excluded, as were patients who had degenerative disease but did not have valve prolapse as a principal mechanism of regurgitation. Additional exclusion criteria were as follows: patients with concomitant pulmonic or aortic valvular pathology, emergent surgery, poor TEE image quality, and exams without all standard MV images. A comprehensive TEE was performed intraoperatively on each patient prior to cardiopulmonary bypass (CPB) as the standard of care in our center. Two hundred TEE examinations (the same cohort of patients from the prior surgical score study1) were rated by two independent cardiac anesthesiologists board certified in advanced echocardiography.