[Functional assessment of the left atrial appendage with transesophageal echocardiography before and after percutaneous valvotomy in the mitral stenosis].
OBJECTIVE
To assess the effects of the relief of the mitral stenosis by percutaneous ballon valvotomy in the function of the left atrial appendage.


METHODS
Twelve patients with symptomatic mitral stenosis, in sinus rhythm, were studied. They were submitted to the transesophageal echocardiogram before and after effective percutaneous ballon valvotomy. Concerning the left atrial appendage, the peak flow velocities and the respective integral of the anterograde and retrograde flow, in addition to the ejection fraction calculated through the planimetry of the area of that structure, were analyzed at the pulsatile Doppler.


RESULTS
There was a significant increase of the anterograde flow velocity of the left atrial appendage after percutaneous ballon valvotomy (pre: mean of 0.30 m/s; post: mean of 0.47 m/s; p<0.05) and their respective integrals. The same happened with the retrograde flow velocity (pre: mean of 0.35 m/s, post: mean of 0.53 m/s; p<0.05). There was a tendency of increase of the ejection fraction of the left atrial appendage after the procedure (pre: mean of 20%, post: mean of 31%; p=0.08).


CONCLUSIONS
The effective opening of the stenosed mitral orifice resulting from the percutaneous ballon valvotomy determined an improvement of the flow pattern of the left atrial appendage, which can potentially contribute for the reduction of the embolic risk.
Tatani
Solange Bernardes
SB
Universidade Federal de São Paulo--UNIFESP, São Paulo, Brazil. sbtatani@cardiol.br
Campos Filho
Orlando
O
Fischer
Claudio Henrique
CH
Moisés
Valdir Ambrósio
VA
Souza
José Augusto Marcondes de
JA
Alves
Cláudia Maria Rodrigues
CM
Paola
Angelo Amato Vincenzo de
AA
Carvalho
Antonio Carlos C
AC
D000293:Adolescent; D000328:Adult; D020517:Atrial Appendage / Q000000981:diagnostic imaging / Q000503:physiopathology*; D016279:Atrial Function, Left / Q000502:physiology*; D001783:Blood Flow Velocity; D017115:Catheter Ablation; D002404:Catheterization; D015150:Echocardiography, Doppler; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008946:Mitral Valve Stenosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*