Prediction of change in mitral valve area after mitral balloon commissurotomy using cine computed tomography.
OBJECTIVE
Mitral balloon commissurotomy (MBC) can successfully increase the mitral valve area (MVA) in mitral stenosis, but the outcome is variable. In multicenter studies, qualitative echocardiographic scores obtained before MBC are only weakly predictive of the increase in MVA after MBC.


METHODS
To evaluate whether the change in MVA after MBC can be predicted by evaluating mitral valve morphology using cine computed tomography (CT), we studied 12 women with mitral stenosis and 11 female control subjects.


RESULTS
In the patients with mitral stenosis, MVA increased from 1.13 +/- 0.24 to 1.93 +/- 0.56 cm2 (P < .0001) after MBC. A standard echocardiographic score assessment of mitral valve morphology before MBC was not associated with the change in MVA after MBC in these patients (P > .20). However, the total mitral valve morphology score evaluated by cine computed tomography was strongly associated with the change in MVA after MBC (r = -.87; P < .0005). In addition, the individual morphologic characteristics of mitral valve mobility (P < .0025), leaflet thickness (P < .05), and subvalvular disease (P < .05) were significant predictors of the change in MVA after MBC.


CONCLUSIONS
Cine computed tomography may be useful for predicting immediate increases in MVA in patients after MBC and may be helpful for preoperative assessment of these patients.
White
M L
ML
Department of Internal Medicine, University of Iowa, Iowa City.
Grover-McKay
M
M
Weiss
R M
RM
Vandenberg
B F
BF
Burns
T L
TL
Winniford
M D
MD
Stanford
W
W
McKay
C R
CR
D002404:Catheterization; D002933:Cineradiography; D015150:Echocardiography, Doppler; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000628:therapy*; D015588:Observer Variation; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed