+ 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

Extension of calcific deposits in the anterior mitral valve leaflet and mitral valve stenosis severity. Use of 2D Echo parasternal long-axis view

Extension of calcific deposits in the anterior mitral valve leaflet and mitral valve stenosis severity. Use of 2D Echo parasternal long-axis view

Acta Cardiologica 38(5): 443-453

To evaluate the role of the extent of calcific deposits on the anterior mitral leaflet in predicting the severity of mitral valve stenosis, two-dimensional echocardiography (2D Echo) and heart catheterization data were analysed in 62 patients with mitral valve stenosis, pure or associated with trivial valve regurgitation. 50 patients had technically adequate 2D Echo. Of these, 28 had pure mitral valve stenosis. The mitral valve area was estimated from the parasternal short-axis 2D Echo projection. Using the parasternal long-axis projection, calcium deposits location and extension on the anterior mitral leaflet was examined. Patients were subdivided into the following groups: Group 0 (absence of calcium deposits = 19 patients), Group 1 (calcium on distal third of the leaflet = 19 patients), Group 2 (calcium on mid and distal segments = 11 patients), Group 3 (calcium on the entire leaflet = one patient). The extension of calcium deposits in long-axis projection was contrasted with 2D Echo mitral valve area in the 50 mitral valve patients. 2D Echo and heart catheterization derived mitral valve area were compared to each other in the 28 patients with pure mitral valve stenosis. 2D Echo mitral valve area was greater in Group 0 patients (1.8 +/- 0.4 cm2) than in Group 1 (1.4 +/- 0.4 cm2) and in Group 2 (1.1 +/- 0.3 cm2) (p less than 0.001 between the three groups). Calcific deposits were present on the anterior mitral leaflet in 30/31 patients with 2D Echo mitral valve area less than or equal to 2 cm2. However, of the 19 patients of Group 0, 13 had moderate and one severe mitral valve stenosis. In the 28 patients with pure mitral valve stenosis, 2D Echo mitral valve area was excellently correlated with Gorlin's derived mitral valve area (r = 0.90). However, in patients with extensive calcification of the anterior mitral valve leaflet (Group 2), 2D Echo mitral valve area was significantly greater than the Gorlin's derived area (1.08 +/- 0.20 cm2 versus 0.68 +/- 0.17 cm2; p less than 0.001). In four patients of Group 2, the mitral valve stenosis was moderate by 2D Echo grading and severe by heart catheterization data. Our data suggest that the study of extension of calcific deposits on the anterior mitral valve leaflet may be a complementary aid in quantifying mitral valve stenosis to the 2D Echo mitral valve area estimate, especially when the valve is severely calcified.

Please choose payment method:

(PDF emailed within 1 workday: $29.90)

Accession: 043094415

Download citation: RISBibTeXText

PMID: 6606922

Related references

On the relationships of mitral opening time to mean velocity of the anterior leaflet of the mitral valve in the ultrasonic cardiogram of mitral valve diseases. Zeitschrift fuer Kreislaufforschung 57(9): 848-852, 1968

Severe Mitral Regurgitation Due to a "Folded" Anterior Mitral Valve Leaflet After Bentall Procedure Requiring Mitral Valve Replacement. Journal of Cardiothoracic and Vascular Anesthesia 32(3): 1337-1340, 2018

Critical assessment of two-dimensional echocardiographic estimation of the mitral valve area in rheumatic mitral valve disease: calcific deposits in the valve as a major determinant of the accuracy of the method. European Heart Journal 2(3): 197-203, 1981

Calcific extension towards the mitral valve causes non-rheumatic mitral stenosis in degenerative aortic stenosis: real-time 3D transoesophageal echocardiography study. Open Heart 1(1): E000136, 2014

Retained anterior mitral valve leaflet following mitral valve replacement a cause for false positive diagnosis of prosthetic valve thrombus. Journal of Cardiovascular Technology 9(4): 361-365, 1990

Surgical indications in mitral valve stenosis, combined mitral valve defect or mitral valve insufficiency. Long-term prognosis of operated or drug-treated patients. Herz 11(2): 74-87, 1986

Long or redundant leaflet complicating transcatheter mitral valve replacement: Case vignettes that advocate for removal or reduction of the anterior mitral leaflet. Catheterization and Cardiovascular Interventions 92(3): 627-632, 2018

Relationship between clinical and echocardiographic criteria for mitral valve prolapse reevaluation employing the parasternal long axis view. American Journal of Noninvasive Cardiology 4(2): 91-96, 1990

Extent of mitral calcific deposits determined by cineangiography in mitral stenosis and their effect on valve motion hemodynamics and clinical signs. American Journal of Cardiology 58(1): 121-128, 1986

Discordance between mitral valve area (MVA) and pressure gradient in patients with mitral valve stenosis: mean transmitral valve gradient is a severity index or a tolerance index of severity of mitralss valve stenosis?. Pan African Medical Journal 25: 75-75, 2017

Mitral commissurotomy or mitral valve replacement. Comparison of results of closed and open operative procedures in acquired mitral valve stenoses and combined mitral valve defects, predominantly stenosis. Zentralblatt für Chirurgie 109(21): 1380-1390, 1984

Transapical valve-in-ring mitral valve implantation through the anterior mitral valve leaflet. European Journal of Cardio-Thoracic Surgery 54(6): 1140-1141, 2018

Influence of involvement of anterior leaflet versus posterior leaflet on residual regurgitation as assessed by transesophageal echocardiography in patients undergoing valve repair for mitral regurgitation due to mitral valve prolapse. Cardiovascular Ultrasound 7: 54, 2009

Critical role of the mitral valve leaflet in hypertrophic subaortic stenosis and amelioration of the disease by mitral valve replacement. Chest 59(4): 378-382, 1971

Mitral valve area during exercise after restrictive mitral valve annuloplasty: importance of diastolic anterior leaflet tethering. Journal of the American College of Cardiology 65(5): 452-461, 2015