Grant: CIHR Fellowship

Over the last few years the fast-paced developments in devices used for mitral and aortic valve repair and replacement have created a need for newer and more accurate methods to assess both mitral and aortic valve function and their interactions with each other. In the heart, the mitral and aortic valves are linked through fibrous tissues connecting the two valves. This three-dimensional (3D) structure has been difficult to evaluate using traditional two-dimensional (2D) imaging methods. Consequently, in humans, these valves have been studied separately as if their function was independent of each other. In animals, these valves have been studied in 3D but by using invasive markers. At this time to evaluate these two valves, patients undergo ultrasound of the heart by passing the ultrasound device down the esophagus (transesophageal echocardiogram) and real-time 3D ultrasound of the heart through the chest wall (transthoracic echocardiogram). Transesophageal and 3D transthoracic echocardiograms are effective tools in helping decide the reparability of these valves through surgery. Recently, a new transesophageal ultrasound device, matrix transesophageal (mTEE) 3D imaging, was developed that allows evaluation of the mitral and aortic valve interaction. It has been used to look at normal aortic-mitral valve interactions. This project aims to use mTEE 3D imaging to understand the changes to aortic-mitral valve interactions when either the aortic or mitral valve or both are repaired and or replaced. The post-surgical finding of a restored, normal aortic-mitral valve interaction versus persistent abnormal interaction may explain the varied patient outcomes after various surgical interventions. These results will provide valuable insight into the techniques currently used in valve surgery and help evolve new devices for valve repair/replacement. Additionally this may establish mTEE 3D as an important clinical tool during mitral and aortic valve surgery.