The aim of the study was to estimate the significance of intraoperative transesophageal 3D-echocardiography (3D-TEE) in determination of possibility, expected volume, complexity and efficacy of mitral valve (MV) surgery in patients with different origin of the mitral regurgitation (MR).

Materials and methods. The study included 64 patients with significant mitral MR (degenerative, arrhythmogenic and ischemic origin): 49 (77%) patients underwent MV repair and 15 (23%) patients - MV replacement. The mean age was 52,2 ± 13,2 years. Twenty patients without MV pathology were included in the control group (12 men and 8 women), mean age was 58 ± 13 years. For all patients undergoing MV repair the valve geometry was assessed intraoperatively using 3D-TEE with Mitral Valve Quantification (MVQ) software before the main stage of the surgery and compared with data in patients of the control group.

Results. comparing the data of patients with MR and patients of the control group, we obtained the following results: myxomatous degeneration is characterized by MV vertical and horizontal deformation and leaflets prolapse into LA; arrhythmogenic MR is associated with dilatation of MV;   ischemic MR is characterized by loss of saddle-shaped of MV.

Conclusion. Real-time (RT) 3D-TEE with MVQ software allow to determine the specific changes in MV geometry depending on  the MR etiology, to select optimal surgical technique, to predict complexity of surgery for each patient in the operating room and to evaluate the efficiency of procedure.