Determination of Mitral Valve Area by Cross-Sectional Echocardiography

Wann, L. Samüel; Weyman, Arthur E.; Feigenbaum, Harvey; Dillon, James C.; Johnston, K. Wayne; Eggleton, R. C.

doi:10.7326/0003-4819-88-3-337

Cited by 125 publications

(31 citation statements)

References 14 publications

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“…Thus, clinical experience -our own and that reported by three independent laboratories -indicates that crosssectional echocardiography provides a reliable measure of MVA. [12][13][14][15] Closed, instrumental commissurotomy using a transventricular mitral valve dilator was done in 17 of 18 patients; one patient had open commissurotomy. Since techniques in cardiopulmonary bypass have improved, open commissurotomy currently appears to be the operation of choice and closed commissurotomy is less frequently done.…”

Section: Discussionmentioning

confidence: 99%

Long-term changes in mitral valve area after successful mitral commissurotomy.

et al. 1979

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SUMMARY We examined the long-term effects of closed instrumental mitral commissurotomy on mitral valve area (MVA) in 18 patients, followed for as long as 14 years after successful operation. Each patient had preoperative and early postoperative cardiac catheterization; a late postoperative determination of MVA was obtained 10-14 years (mean 12.2 years) after commissurotomy. In 17 patients, the MVA was determined by cross-sectional echocardiography and in one patient by repeat cardiac catheterization. Thirteen of 18 patients had no change in MVA between early postoperative study (mean MVA = 2.7 cm2) and late postoperative study (mean MVA = 2.9 cm2). MVA in five patients decreased 0.7-2.2 cm2 (mean 1.4 cm2) during the followup period. In these five patients, the mean MVA at early postoperative study was 2.7 cm2 and at late postoperative study was 1.3 cm2 (p < 0.001). At late postoperative evaluation, cardiac symptoms were associated with severity of mitral stenosis but did not predict restenosis. A successful, closed, instrumental mitral commissurotomy can provide substantial long-term improvement in MVA.RHEUMATIC MITRAL STENOSIS is an acquired form of valvular heart disease characterized by diffuse thickening of the mitral leaflets, fusion of the commissures, and shortening and fusion of the chordae tendineae. These pathologic lesions combine to decrease the size of the 'mitral valve orifice, thereby restricting the flow of blood into the left ventricle. When the decrease in mitral valve area (MVA) becomes critical, surgical correction of the valvular lesion is frequently required. Surgical improvement in MVA may be accomplished by prosthetic mitral valve replacement, or, in selected cases, by mitral commissurotomy. Mitral commissurotomy appears to be preferable, since the operative morbidity and mortality are less and postoperative complications fewer than those associated with valve replacement.There is concern, however, that restenosis of the valve may occur after a successful commissurotomy, necessitating a second commissurotomy or a valve replacement. On the basis of clinical and hemodynamic studies, many investigators report that reoperation is often required after a commissurot- the long-term changes in MVA after commissurotomy, they have been limited to either rightheart catheterization data or the study of primarily those patients with recurrent symptoms.6"-As a result, data concerning the overall, long-term effects of successful mitral commissurotomy on the MVA in patients with and without recurrent symptoms are unavailable. This is important information, since the decision to perform a commissurotomy depends, in part, on the expected long-term results. We report our findings in a group of patients who had a documented successful commissurotomy, and who were then followed for as long as 14 years to determine the long-term effects of the operation on MVA and the incidence of restenosis. Methods To determine the long-term effects of mitral valve commissurotomy on MVA, we studied only patients who had pure...

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Section: Discussionmentioning

confidence: 99%

Long-term changes in mitral valve area after successful mitral commissurotomy.

et al. 1979

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“…388 -393 Echocardiography is able to identify restricted diastolic opening of the MV leaflets due to "doming" of the anterior leaflet and immobility of the posterior leaflet. 388,390,392,393 Other entities that can simulate the clinical features of rheumatic MS, such as left atrial myxoma, mucopolysaccharidosis, nonrheumatic calcific MS, cor triatriatum, and a parachute MV, can be readily identified by 2D echocardiography. Planimetry of the orifice area may be possible from the short-axis view.…”

Section: Indications For Echocardiography In Mitral Stenosismentioning

confidence: 99%

2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease

Bonow¹,

Carabello²,

Chatterjee³

et al. 2008

Circulation

910

259

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“…Previous studies have documented the close correlation between mitral valve area detennined by twodimensional (2-D) echocardiography and that obtained by cardiac catheterization or direct measurement at surgery in patients with mitral stenosis (Henry et al, 1975;Nichol et al, 1977;Wann et al, 1978). In fact the 2-D echocardiographic measurements of mitral valve orifice size have been so accurate that it has been suggested that the assessment of the severity of mitral stenosis by 2-D echocardiography may be superior to that provided by cardiac catheterization in patients with concomitant mitral regurgitation or other valvular lesions (Henry et al, 1975;Wann et al, 1978).…”

Section: Introductionmentioning

confidence: 99%

“…In fact the 2-D echocardiographic measurements of mitral valve orifice size have been so accurate that it has been suggested that the assessment of the severity of mitral stenosis by 2-D echocardiography may be superior to that provided by cardiac catheterization in patients with concomitant mitral regurgitation or other valvular lesions (Henry et al, 1975;Wann et al, 1978).…”

Section: Introductionmentioning

confidence: 99%

Correlation between calcific aortic stenosis diagnosed by two‐dimensional echocardiography and cardiac catheterization

Nair

Aronow

Sketch

et al. 1984

Clinical Cardiology

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Summary: This retrospective study correlates the severity of calcific aortic stenosis detennined by twodimensional (2-D) echocardiography with the aortic valve area determined by catheterization in 57 patients. Aortic valve leaflet calcification was diagnosed by cineangiography in 50 (88 %) of 57 patients and by 2-D echo in 57 (100%) of 57 patients (p<0.025). An agreement between severity of aortic stenosis by catheterization and 2-D echo occurred in 22 (39%) of 57 patients. Chisquare and logistic regression analyses showed no correlation between the severity of aortic stenosis and the 2-D echo variables: left ventricular wall thickness, left ventricular diastolic dimension, left ventricular systolic dimension, aortic root diameter, and left atrial dimension. We conclude that 2-D echo detects aortic leaflet calcification better than cineangiography. However, the severity of aortic stenosis determined by 2-D echo correlates poorly with the severity of aortic stenosis determined by cardiac catheterization.

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Determination of Mitral Valve Area by Cross-Sectional Echocardiography

Cited by 125 publications

References 14 publications

Long-term changes in mitral valve area after successful mitral commissurotomy.

Long-term changes in mitral valve area after successful mitral commissurotomy.

2008 Focused Update Incorporated Into the ACC/AHA 2006 Guidelines for the Management of Patients With Valvular Heart Disease

Correlation between calcific aortic stenosis diagnosed by two‐dimensional echocardiography and cardiac catheterization

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