Comparative value of transthoracic and transoesophageal echocardiography before balloon dilatation of the mitral valve.
OBJECTIVE
To assess the relative merits of transthoracic and transoesophageal echocardiography before balloon dilatation of the mitral valve.


METHODS
Transthoracic and transoesophageal echocardiograms were prospectively performed in 35 patients being considered for balloon dilatation of the mitral valve. Echocardiograms were analysed for image quality, the assessment of valve morphology, the detection of left atrial thrombus, and the assessment of mitral regurgitation and other valvar pathology.


METHODS
35 consecutive patients with symptomatic dominant mitral stenosis.


METHODS
30 eventually underwent balloon dilatation of the mitral valve by the Inoue technique. Five patients had mitral valve replacement.


METHODS
Echocardiographic and surgical detection of left atrial thrombus and successful, uncomplicated balloon dilatation of the mitral valve.


RESULTS
Left atrial thrombus was detected in 1/35 patients by transthoracic studies compared with 6/35 from transoesophageal studies. Otherwise both techniques gave comparable results. Thrombus was confirmed at mitral valve replacement in five patients. Successful dilatation of the mitral valve was performed in 30 patients.


CONCLUSIONS
Transthoracic echocardiography is a useful screening procedure but transoesophageal echocardiography is mandatory before balloon dilatation of the mitral valve for the detection of left atrial thrombus.
Thomas
M R
MR
Department of Cardiology, King's College Hospital, Denmark Hill, London.
Monaghan
M J
MJ
Smyth
D W
DW
Metcalfe
J M
JM
Jewitt
D E
DE
D000328:Adult; D000368:Aged; D002404:Catheterization / Q000379:methods*; D004452:Echocardiography / Q000379:methods*; D004947:Esophagus; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging* / Q000628:therapy; D013909:Thorax; D013927:Thrombosis / Q000000981:diagnostic imaging