title: Transesophageal echocardiography in comparison with magnetic resonance imaging in the diagnosis of pulmonary vein stenosis after radiofrequency ablation therapy.
abstract: OBJECTIVE
  Doppler-derived flow velocity measured by transesophageal echocardiography (TEE) may overestimate pulmonary vein stenosis. We hypothesized that combining peak velocity with a stenotic flow pattern improves diagnosis compared with magnetic resonance imaging (MRI).
  
  
  METHODS
  TEE and MRI were performed in 44 patients 19 +/- 11 months after radiofrequency catheter ablation. Pulmonary vein stenosis was defined by a peak velocity of 110 cm/s or more plus a stenotic flow pattern (turbulence and reduced flow variation) on TEE and a lumen reduction of more than 50% on MRI.
  
  
  RESULTS
  In all, 175 pulmonary veins were studied. MRI showed 7 cases of pulmonary vein stenosis that were correctly identified by TEE. In addition, TEE criteria for pulmonary vein stenosis were met in 4 pulmonary veins that did not show obstruction on MRI. In all, 5 pulmonary veins with normal appearance on MRI had peak velocity of 110 cm/s or more with normal flow pattern.
  
  
  CONCLUSIONS
  TEE Doppler measurements can be reliably used to detect or exclude significant pulmonary vein stenosis if the diagnosis is restricted to a combination of elevated peak velocity (> or = 110 cm/s) with turbulence and little flow variation.
authors.affiliation: Herz-Zentrum, Bad Krozingen, Germany. nikolaus.jander@herzzentrum.de
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Jander
authors.forename: Jan
authors.initials: J
authors.lastname: Minners
authors.forename: Thomas
authors.initials: T
authors.lastname: Arentz
authors.forename: Lothar
authors.initials: L
authors.lastname: Görnandt
authors.forename: Rudolf
authors.initials: R
authors.lastname: Fürmaier
authors.forename: Dietrich
authors.initials: D
authors.lastname: Kalusche
authors.forename: Franz Josef
authors.initials: FJ
authors.lastname: Neumann
mesh_terms: D017115:Catheter Ablation / Q000706:statistics & numerical data*; D017548:Echocardiography, Transesophageal / Q000706:statistics & numerical data*; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011668:Pulmonary Veno-Occlusive Disease / Q000175:diagnosis* / Q000453:epidemiology*; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016896:Treatment Outcome