Objective: The procedure of closed mitral commissurotomy under intraope-rative transesophageal echocardiography with color flow Doppler imaging is a valuable approach for treating pure, non-calcific mitral stenosis. The aim of this study was to research the value of intraoperative transesophageal echocardiography during closed mitral commissurotomy.
Methods and Results: Thirty-nine patients with mitral stenosis underwent closed mitral commissurotomy at our clinic. Eleven patients were male and 28 were female, and the average age was 32.6±7.1 years (range, 18-45 years). Preoperatively, all patients were NYHA class III-IV. There were no valve calcification, left atrial thrombus and severe deformity of subvalvular apparatus. The mean mitral valve orifice area as determined by Doppler pressure half time was 0.8±0.3 cm² (range, 0.6-1.3 cm²) with a mean transvalvular gradient of 15.7±2.3 mmHg (range, 12-20 mmHg). After commissurotomy, the valvular competence was assessed by transesophageal echocardiography. Intraopera-tive transesophageal echocardiography findings showed a mean mitral valve orifice area of 2.3±1.2 cm² (range, 2.1-2.8 cm²). None of the patients had significant mitral regurgitation as assessed by color flow Doppler imaging.
Conclusion: In appropriate patients, we believe that transesophageal echocardiography gudiance makes closed mitral commissurotomy a safe, useful, and objective procedure.
Key words: Mitral stenosis, closed mitral commissurotomy, intraoperative transesophageal echocardiography
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