title: Additional value of three-dimensional transesophageal echocardiography for patients with mitral valve stenosis undergoing balloon valvuloplasty.
abstract: The objective of this study was to validate the additional value of 3-dimensional (3D) transesophageal echocardiography (TEE) for patients with mitral valve stenosis undergoing percutaneous mitral balloon valvotomy (PTMV). Therefore, in a series of 21 patients with severe mitral valve stenosis selected for PTMV, 3D TEE was performed before and after PTMV. The mitral valve area was assessed by planimetry pre- and post-PTMV; the mitral valve volume was assessed and attention was paid to the amount of fusion of the commissures. These results were compared with findings by 2-dimensional transthoracic echocardiography using pressure half-time method for assessment of mitral valve area, and were analyzed for the prediction of successful outcome. Pre-PTMV the mitral valve area assessed by 3D TEE was 1.0 +/- 0.3 cm(2) vs 1.2 +/- 0.4 cm(2) assessed by 2-dimensional transthoracic echocardiography (P =.03) and post-PTMV it was 1.8 +/- 0.5 cm(2) vs 1.9 +/- 0.6 cm(2) (not significant), respectively. The mitral valve volume could be assessed by 3D TEE (mean 2.4 +/- 2.5 cm(3)) and was inversely correlated to a successful PTMV procedure (P <.001). The 3D TEE method enabled a better description of the mitral valvular anatomy, especially post-PTMV. We conclude that 3D TEE will have additional value over 2-dimensional echocardiography in this group of patients, for selection of patients pre-PTMV, and for analyzing pathology of the mitral valve afterward.
authors.affiliation: Department of Cardiology, St Antonius Hospital, Koekoekslaan 1, 3435 CM Nieuwegein, The Netherlands. J.Langerveld@ision.nl
authors.forename: Jorina
authors.initials: J
authors.lastname: Langerveld
authors.forename: Gabriel
authors.initials: G
authors.lastname: Valocik
authors.forename: H W Thijs
authors.initials: HW
authors.lastname: Plokker
authors.forename: Sjef M P G
authors.initials: SM
authors.lastname: Ernst
authors.forename: Herman F J
authors.initials: HF
authors.lastname: Mannaerts
authors.forename: Johannes C
authors.initials: JC
authors.lastname: Kelder
authors.forename: Otto
authors.initials: O
authors.lastname: Kamp
authors.forename: Wybren
authors.initials: W
authors.lastname: Jaarsma
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002404:Catheterization; D004452:Echocardiography; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D005260:Female; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000628:therapy; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000628:therapy*; D015588:Observer Variation; D011182:Postoperative Care; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011446:Prospective Studies; D012720:Severity of Illness Index; D013223:Statistics as Topic; D016896:Treatment Outcome