Mitral valve apparatus : echocardiographic features predicting the outcome of percutaneous mitral balloon valvotomy
Date
2007-06
Authors
Du Toit, R.
Brice, E. A. W.
Van Niekerk, J. D.
Doubell, A. F.
Journal Title
Journal ISSN
Volume Title
Publisher
Clinics Cardiv Publishing
Abstract
Objectives: To evaluate the significance of involvement of
subvalvular apparatus in the outcome of percutaneous
mitral balloon valvotomy (PMBV) in patients with mitral
stenosis (MS) and to determine the predictive value of
chordal length compared with current echocardiographic
scores.
Methods: Patients with significant MS were selected according
to the Massachusetts General Hospital score (MGHS).
Chordal lengths were assessed as additional markers of
disease. Standard percutaneous valvotomies were performed.
Valve area was assessed post-procedure with follow-up over
one year.
Results: Thirty-nine patients were prospectively studied.
Valve area increased from a mean (SD) 0.97 (0.26) cm²
to 1.52 (0.38) cm² with procedural success in 31 (79.5%)
patients. There was no correlation (r = 0.09) between the
MGHS and final valve area (FVA). There was a positive
correlation between anterior chordal length and FVA (r =
0.66; p = 0.01). An FVA ≥ 1.5 cm² was associated with higher
mean chordal lengths (p = 0.01). A positive correlation was
seen between valve area pre-procedure and FVA (r = 0.61;
p < 0.01).
Conclusions: The MGHS is valuable in the selection of
patients for PMBV, but fails to separate selected patients into
prognostic groups. Assessment of chordal length provides
useful additional information, predicting the outcome of
PMBV more accurately. Our data may support the earlier
use of PMBV (asymptomatic patients).
Description
The original publication is available at http://www.cvja.co.za
Keywords
Mitral stenosis, Percutaneous mitral balloon valvotomy
Citation
Du Toit, R., Brice, E.A.W., Van Niekerk, J.D., & Doubel, A.F. 2007. Mitral valve apparatus: echocardiographic features predicting the outcome of percutaneous mitral balloon valvotomy. Cardiovascular journal of Africa, 18(3), 159-174