+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Advantage of color Doppler flow imaging in the assessment of mitral regurgitation and atrial septal defect after percutaneous mitral valvotomy



Advantage of color Doppler flow imaging in the assessment of mitral regurgitation and atrial septal defect after percutaneous mitral valvotomy



American Journal of Noninvasive Cardiology 6(6): 333-338



Doppler echocardiography and color Doppler flow imaging were used to assess the results of percutaneous mitral valvotomy in 293 consecutive patients aged 16-86 years (mean age 52.4 +- 13.5). Doppler examinations were performed the day before as well as within 2 days and 3 months after valvotomy. The first 161 procedures were carried out using the double-balloon technique and the last 132 using the Inoue technique. Mitral valve area, calculated according to the Gorlin formula, increased on average from 1.0 +- 0.3 to 2.0 +- 0.5 cm-2 (p lt 0.0001) and the mean gradient dropped on average from 12.5 +- 4 to 5 +- 2 mm Hg(p lt 0.0001). Grade 1+ mitral regurgitation was present in 85 patients (29%) before valvotomy when estimated from left ventricular angiography. After valvotomy, it worsened to grade 2+ in 19 patients (6%) and to grade 3+ or 4+ in 5 cases (1.7%). Grade 1+, 2+ and 3+ mitral regurgitation appeared in 28 (9.5%), 5 (1.7%) and 6 patients (2%), respectively. Grade 1+ mitral regurgitation was detected by color Doppler in 159 patients (54%) before valvotomy. After the procedure, it worsened to grade 2+ in 16 patients (5%) and to grade 3+ or 4+ in 5 patients (1.7%). Grade 1+, 2+ and 3+ mitral regurgitation appeared in 30 (10%), 6(2%) and 2(0.7%) patients, respectively. Mitral regurgitation disappeared after valvotomy in 21 patients (7.2%). The specificity of color Doppler in the detection of mitral regurgitation was questionable when compared to contrast angiography (44%), perhaps because color Doppler may be more sensitive than left ventriculography in the diagnosis of mild mitral regurgitation. All in all, mitral regurgitation quantification determined by color Doppler correlated well with contrast angiography data, with a discrepancy of more than 1 grade in only 6 patients. The location and mechanism of mitral regurgitation were determined using color Doppler. Regurgitation was central in most cases; it was sometimes located on one commissure or on both in 26 cases. Color Doppler visualized an atrial septal defect in 115 patients (39%) on day 2, which persisted in 36 of 96 patients reexamined 3 months later. A shunt inversion was present during deep inhalation in 1 case. No correlation was found between the persistence of disappearance of the shunt and the results of mitral valvotomy.

Please choose payment method:






(PDF emailed within 1 workday: $29.90)

Accession: 009762164

Download citation: RISBibTeXText


Related references

Color doppler follow up of atrial septal defect after mitral percutaneous valvotomy. European Heart Journal 11(ABSTR Suppl.): 336, 1990

Color doppler assessment of iatrogenic atrial septal defect following percutaneous mitral valvuloplasty. Circulation 80(4 Suppl. 2): II168, 1989

Relation of echocardiographic morphology of the mitral apparatus to mitral regurgitation in mitral valve prolapse: assessment by Doppler color flow imaging. American Heart Journal 119(5): 1095-1102, 1990

Evaluation of ventricular septal defect complicating acute myocardial infarction identification localization and differentiation from mitral regurgitation by color doppler flow imaging. Journal of the American College of Cardiology 13(2 Suppl. A): 209A, 1989

Relation of valvular anatomy and coaptation to mitral regurgitation in mitral valve prolapse assessment by color doppler flow imaging. Journal of the American College of Cardiology 11(2 Suppl. A): 126A, 1988

Usefulness of color Doppler flow imaging to distinguish ventricular septal defect from acute mitral regurgitation complicating acute myocardial infarction. American Journal of Cardiology 64(12): 697-701, 1989

Incidence and changes in mitral regurgitation in balloon valvotomy of the mitral valve. A color Doppler study. Casopis Lekaru Ceskych 131(23): 696-699, 1992

Atrial septal defect after percutaneous mitral balloon valvuloplasty estimation of shunt volume and predictors of persistence by color doppler echocardiography. Journal of the American College of Cardiology 17(2 Suppl. A): 70A, 1991

Mitral regurgitation after percutaneous mitral valvotomy in adults evaluation by pulsed doppler echocardiography. Journal Of The American College Of Cardiologypl. A: 217a, 1987

Quantification of mitral regurgitation by real time three-dimensional color Doppler flow echocardiography pre- and post-percutaneous mitral valve repair. Echocardiography 32(7): 1140-1146, 2015

Color flow imaging compared with quantitative Doppler assessment of severity of mitral regurgitation: influence of eccentricity of jet and mechanism of regurgitation. Journal of the American College of Cardiology 21(5): 1211-1219, 1993

Relationship of two-dimensional echocardiographic mitral valve prolapse to mitral regurgitation assessed by color Doppler flow imaging. Journal of Cardiology. Supplement 14: 67-71, 1987

Left atrial systolic antegrade flow in patients with mitral regurgitation: a pulsed Doppler sign displayed by color flow imaging. Journal of the American Society of Echocardiography 2(5): 331-336, 1989

Quantitative assessment of mitral regurgitation by Doppler color flow imaging: angiographic and hemodynamic correlations. Journal of the American College of Cardiology 13(3): 585-590, 1989

Semiquantitative assessment of mitral regurgitation by Doppler color flow imaging in patients aged less than 20 years. American Journal of Cardiology 71(8): 727-732, 1993