Background: The aim of our study is to establish an accurate measurement method for anterior mitral leafl et (AML) free margin length, which is a key aspect for prediction of the extent of resection in anterior mitral valve (MV) leafl et repair.Method: Among the patients who underwent anterior MV leafl et repair between July 2010 and August 2012, we studied 17 patients with data on 3D echocardiography obtained pre- and intra-operatively and intraoperative direct measurements of AML free margin.The AML free margin lengths measured at different frames (early-opening frame of MV and end-opening frame of MV) by using realtime 3D transesophageal echocardiography (RT-3DTEE) were compared with the values directly measured during mitral valvuloplasty (MVP). For acquisition of 3D data during surgery, RT-3DTEE images of MV were obtained by using the Philips iE33 echocardiography system with X7-2 probe before MVP.Result: The free margin length values measured with Q-LAB MVQ. Regarding the correlation between the measured values with the RT-3DTEE and values directly measured intraoperatively, the measured values at the early-opening frame of MV had no correlation between the actual measured values and r-value = 0.338 (P=0.184). Conversely, the measured values at the end-opening frame of MV had an extremely high signifi cant correlation between the measured values and r-value = 0.980 (P<0.0001).Conclusion: In conclusion, the novel measurement method enables measurement of anterior mitral leafl et free margin length by using RT-3DTEE. At the end-opening frame of MV, the novel measurement method that refl ects more accurate actual measured value was established.departmental bulletin pape
