Copyright © 2004 by the European Society of Cardiology.
Clinical research
Non-invasive assessment of mitral valve area during percutaneous balloon mitral valvuloplasty: role of real-time 3D echocardiography
a Echocardiography Laboratory of the Hospital Clínico de San Carlos, Instituto Cardiovascular, 28040 Madrid, Spain
b University Hospital of Chicago, Chicago, USA
Received May 13, 2004; revised September 3, 2004; accepted September 9, 2004 * Corresponding author. Tel.: +34 913303290; fax: +34 913303293 (E-mail: jlzamorano{at}vodafone.es).
See page 2073 for the editorial comment on this article (doi:10.1016/j.ehj.2004.10.001)
BACKGROUND: In the last decade, multiple studies depicted discrepancies between mitral valvular orifice area (MVA) measurements obtained with the pressure half-time (PHT) method and invasive methods during the immediate post-percutaneous mitral valvuloplasty (PMV) period. Our aim was to assess the accuracy of Real-Time 3D echo (RT3D) to measure the MVA in the immediate post-PMV period. The invasively determined MVA was used as the gold standard.
METHODS AND RESULTS: We studied 29 patients with rheumatic mitral stenosis from two centres (27 women; mean age 48.2±11.3 years), all of which had underwent PMV. MVA was calculated before and after PMV using the PHT method, 2D echo planimetry, RT3D echo planimetry and invasive determination (Gorlin's method). The RT3D MVA assessment showed a better agreement with the invasively derived MVA before and in the immediate post-PMV period (Bland-Altman analysis: Average difference between both methods and limits of agreement: 0.01 (–0.31 to 0.33) cm2 and –0.12 (–0.71 to 0.47) cm2) before and immediately after the PMV, respectively.
CONCLUSIONS: RT3D is a feasible and accurate technique for measuring MVA in patients with RMVS. It has the best agreement with the invasively determined MVA, particularly in the immediate post-PMV period.
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