Detection of dysfunctioning mitral prosthetic regurgitation: transesophageal echocardiography in comparison with transthoracic echocardiography and angiography.
Transesophageal echocardiography has been increasingly used in addition to the transthoracic approach. It not only allows an unobstructed window for viewing the left atrium, but also provides high-quality imaging to improve diagnosis of prosthetic valve dysfunction. To determine the value of transesophageal echocardiography in detection of dysfunctioning mitral prosthetic regurgitation, 11 patients clinically suspected of dysfunctioning mitral prosthesis were studies by transthoracic, transesophageal echocardiography and was documented by a left ventricular angiography. There were 7 biological tissue valves and 4 metallic Bjork-Shiley valves. Compared with a left ventricular angiography, the transthoracic approach to 8 patients made an underestimation of the grade of regurgitation. The angiographic grading confirmed the transesophageal approach in all patients except one who was graded as mild regurgitation by left ventricular angiography, moderate regurgitation by transesophageal echocardiography, but no regurgitation by transthoracic echocardiography. Our results indicated that in patients with suspected mitral prosthetic dysfunction, a transesophageal echocardiography is more sensitive than a transthoracic echocardiography in detecting mitral regurgitation.
Ku
C S
CS
Division of Cardiology, Tri-Service General Hospital, Taipei, R.O.C.
Hsiung
M C
MC
Hsu
T L
TL
Ding
Y A
YA
Wang
D J
DJ
Shieh
S M
SM
Lin
K C
KC
Chiang
B N
BN
D000328:Adult; D000792:Angiography; D001705:Bioprosthesis; D015150:Echocardiography, Doppler / Q000379:methods*; D005260:Female; D006350:Heart Valve Prosthesis; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D008944:Mitral Valve Insufficiency / Q000175:diagnosis* / Q000209:etiology; D011237:Predictive Value of Tests; D011475:Prosthesis Failure