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.