Three-dimensional Echocardiography: A Novel Technique for Rheumatic Mitral Valve Stenosis Evaluation
Journal Title: INTERNATIONAL JOURNAL OF SCIENTIFIC STUDY - Year 2017, Vol 5, Issue 1
Abstract
Introduction: This study aimed to assess which echocardiographic method has the best agreement with the mitral valve area (MVA) invasively evaluated by the Gorlin’s formula and also to evaluate the feasibility and reproducibility of three-dimensional (3D) echocardiography for the estimation of MVA and Wilkins score in patients with rheumatic mitral stenosis (RHMS). Materials and Methods: This study is a comparative study. This study was conducted to describe the various methods of MV assessment in patients with RHMS. We hypothesized that, since 3D echocardiography allows a different and superior evaluation of MV apparatus, this technique could increase the ability to perform an accurate MVA planimetry immediately after a percutaneous mitral commissurotomy (PTMC). The use of the new transthoracic 3D matrix array probe (Philips, IE33) allows online 3D rendering of cardiac structures, enabling a fast and accurate analysis of cardiac structures. Results: Fifty consecutive patients with RHMS comprised our study group. There were 32 (64%) women, and the mean age was 32.5±10 years. The mean LA size was 4.83±0.93 cm. Mitral peak gradient was 25.7±6.1 mmHg and mitral mean gradient was 15.5±4.2 mmHg. Mitral stenosis was the predominant valve lesion in all of them, but concomitant mitral regurgitation grade I/II was present in four patients and aortic regurgitation grade II/III was present in two patients. Forty-two patients were in normal sinus rhythm and eight in atrial fibrillation. Conclusion: Transthoracic 3D echocardiography is a feasible and accurate technique for measuring MVA in patients with RHMS in pre, intra, and post-PTMC states compared to the pressure half-time method, proximal isovelocity surface area and 2D echo planimetry.
Authors and Affiliations
S R Veeramani
Keywords
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