[Transesophageal echocardiography assessment of regurgitant jets of eccentric geometry in mitral valve prosthesis: superiority of multiplanar sections over standard sections].

Abstract

OBJECTIVE:

The purpose of this study was to determine whether multiplanar (MP) transesophageal echocardiographic views were superior to standard views (ST) at 0 degree and 90 degrees in the evaluation of mitral prosthesis regurgitation (MR), particularly in presence of wall regurgitant jets.

DESIGN:

Comparison between MP and ST views in the evaluation of mitral prosthesis regurgitation.

SETTING:

Laboratory of Echocardiography of the General Hospital Gregorio Marañon.

MATERIAL AND METHODS:

Study of all mitral prostheses in which pathological mitral regurgitation had been detected by multiplanar TEE, between January 1993 and March 1994. Regurgitation prosthesis were classified in two groups according to the presence of wall regurgitation jets and maximum turbulent color flow areas (MAX) were measured on standard (0 degree and 90 degrees) and MP (0 degree to 180 degrees) views. The sample was divided in two groups, A (n = 33): with wall jets and B (n = 10): without wall jets. Students' t test was used to compare both areas using a 95% confidence interval (95% c.i.).

RESULTS:

MAX detected on ST views were of 5.80 +/- 4.60 cm2 and on MP were of 7.42 +/- 5.13 cm2 being the difference statistically significant: 1.61 cm2, 95% c.i. from 0.94 to 2.28 cm2, p = 0.000025. MAX for group A was of 5.64 +/- 4.30 cm2 in ST views and of 7.51 +/- 5.12 cm2 in MP views, being the difference 1.86 cm2, 95% c.i. from 1.04 to 2.68; p = 0.00009. Differences for group B were also statistically significant: 0.68 cm2, p = 0.0176. Mitral regurgitation (MR) was classified as mild, moderate and severe according to the color flow area. MP views detected a severer degree of MR than ST views in 8 patients, all of them with wall regurgitation jets. Three of these cases had been considered normal on ST views.

CONCLUSIONS:

Multiplanar transesophageal views are significantly superior to standard views in the assessment of regurgitant prosthetic mitral valves, particularly in presence of wall regurgitant jets. Our data strongly suggest that multiplanar TEE is the procedure of choice in the assessment of wall regurgitant mitral prostheses.

• Authors: R C Sousa, M A Garcia-Fernandéz, J F Bobadilha, M Moreno, P Garrido, E G Torrecilla, D S Roman, J Bermejo, J L Delcán
• Journal: Revista portuguesa de cardiologia : orgao oficial da Sociedade Portuguesa de Cardiologia = Portuguese journal of cardiology : an official journal of the Portuguese Society of Cardiology (Rev Port Cardiol) Vol. 13 Issue 12 Pg. 919-27, 892 (Dec 1994) ISSN: 0870-2551 [Print] Portugal
• Vernacular Title: Avaliação por ecocardiografia transesofágica dos jactos regurgitantes de geometria excêntrica em válvulas protésicas mitrais: superioridade das secções de corte multiplanares sobre as secções standard.
• PMID: 7873222 (Publication Type: Clinical Trial, Comparative Study, Journal Article)

Topics

• Adult
• Aged
• Echocardiography, Transesophageal (methods)
• Female
• Heart Valve Prosthesis (adverse effects)
• Humans
• Male
• Mathematics
• Middle Aged
• Mitral Valve Insufficiency (diagnostic imaging, etiology)