Document Detail


Biplane transesophageal color Doppler echocardiography for assessment of mitral valve area with mitral inflow jet widths.
MedLine Citation:
PMID:  7755997     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Biplane transesophageal color Doppler echocardiography can image the mitral valve orifice in two orthogonal views. If the maximal stenotic jet width through the mitral valve obtained with the vertical transducer represents the major axis, the stenotic jet width dissected by the horizontal transducer should be the minor axis of the mitral orifice. Thus the mitral valve area can be calculated assuming an oval shape of mitral orifice. Nineteen patients with mitral stenosis were investigated. Maximal mitral stenotic jet width (JW1) was searched on a vertical plane and the jet width from the orthogonal view (JW2) was obtained on a horizontal plane. Mitral valve areas from the color Doppler jet widths were calculated by pi.JW1/2.JW2/2 and compared with those derived from Gorlin's formula. Adequate quality of echocardiographic images could be obtained in all patients for transesophageal color Doppler jet width measurements or Doppler pressure half-time determinations and in 16 of 19 patients for transthoracic planimetery of the mitral orifice at the parasternal short axis. Mitral valve areas derived from biplane transesophageal color Doppler imaging (1.31 +/- 0.53 cm2) were not different from those calculated according to Gorlin's formula from the catheterization data (1.25 +/- 0.50 cm2), those determined by transthoracic echocardiographic planimetery (1.38 +/- 0.5 cm2), or those calculated from the Doppler pressure half-time method (1.32 +/- 0.41 cm2) (difference not significant by analysis of variance). There was a very strong correlation between transesophageal echocardiographic mitral valve areas and those derived from catheterization data (r = 0.94; standard error of the estimate = 0.13 cm2). A similar correlation was obtained for the planimetric echocardiographic method (r = 0.94; standard error of the estimate = 0.14 cm2). A slightly less strong correlation was found between mitral valve areas derived from the Doppler pressure half-time method and those derived from Gorlin's formula (r = 0.83; standard error of the estimate = 0.24 cm2). The pressure half-time method accurately predicted the mitral valve area in most (15/19) patients, but it significantly (> 0.4 cm2) overestimated mitral valve area in two patients with aortic regurgitation and underestimated (< 0.4 cm2) mitral valve area in two patients with left ventricular hypertrophy. Determination of mitral valve area by color Doppler biplane transesophageal echocardiography is an alternative for accurate estimation of mitral valve area and may be most useful in intraoperative monitoring during surgical or balloon mitral commissurotomy or in the case of inadequate imaging quality of transthoracic echocardiography.
Authors:
C Chen; B Schneider; D Koschyk; L Chen; T Shuaib; C Hamm; L Gillam; W Kupper; T Meinertz
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Journal of the American Society of Echocardiography : official publication of the American Society of Echocardiography     Volume:  8     ISSN:  0894-7317     ISO Abbreviation:  J Am Soc Echocardiogr     Publication Date:    1995 Mar-Apr
Date Detail:
Created Date:  1995-06-29     Completed Date:  1995-06-29     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8801388     Medline TA:  J Am Soc Echocardiogr     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  121-31     Citation Subset:  IM    
Affiliation:
Department of Cardiology, University Hospital Hamburg, Germany.
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MeSH Terms
Descriptor/Qualifier:
Adult
Echocardiography, Doppler, Color / methods*
Echocardiography, Transesophageal / methods*
Feasibility Studies
Female
Heart Catheterization
Humans
Male
Mitral Valve / ultrasonography*
Mitral Valve Insufficiency / ultrasonography
Mitral Valve Stenosis / ultrasonography*
Rheumatic Heart Disease / ultrasonography*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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