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European Heart Journal 1991 12(Supplement B):61-65; doi:10.1093/eurheartj/12.suppl_B.61
Copyright © 1991 by the European Society of Cardiology.
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© 1991 The European Society of Cardiology

Transoesophageal echocardiography in the assessment of percutaneous mitral commissurotomy

B. Cormier, A. Vahanian, P. L. Michel, J. M. Porte, B. Iung, E. Dadez and J. Acar

Hôpital Tenon, rue de la Chine 75970 Paris, Cedex 20, France

Correspondence: B. Cormier, MD, Hôpital Tenon, 4 Rue de la Chine, 75970 Paris, Cedex 20, France.

The aim of this study was to assess the value of transoesophageal echo (TEE) in comparison with transthoracic echocardiography (TTE) in selecting candidates and evaluating the results of percutaneous miral commissurotomy (PMC). One hundred and ten patients (pts) were examined by TEE and TTE before PMC. PMC was not performed in eight pts who had a thrombus in the left atrium detected by TEE but not by TTE. Out of the 102 other pts, TEE was better than TTE in detecting mild mitral regurgitation (MR) (84 us 38, P <0·01). Spontaneous contrast was only shown by TEE in 70pts. On the other hand, planimetry of the valvular area was only possible with TTE. This technique was also better in the assessment of the commissural area.

During PMC, TEE enabled the interatrial septum to be punctured in two pts. After PMC, MR wnr trivial in 49 TEE cases compared with 36 by TTE and was moderate in 20 TEE pts compared with 12 by TTE (P < 0·02). Transoesopheal colour Doppler showed a trivial atrial shunt in 63% of cases vs 13% by TTE (P<0·01). A small atrial septal defect was found in 30 cases only by TEE, and a spontaneous contrast persisted in all pts but six with moderate MR.

In conclusion, TEE provides useful information in the ultrasonic assessment of PMC in particular with left atrial thrombi, mitral regurgitation, and the post PMC atrial septal defect. However, both methoads are complementary and only TTE enables calculation of valve area.

Key Words: Transoesophageal echocardiography • mitral stenosis


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