Study with reflected ultrasound of patients with mitral valve repair.

Abstract

As part of a follow-up investigation in mitral annuloplasty by reflected ultrasound, 39 studies have been carried out in I5 patients who underwent mitral valve reconstructive operations. The rate of diastolic toward closure movemeiit from point E (EF speed) and total amplitude did not correlate with the final valve orifice dimension obtained at operation. Mitral stenosis and incompetence were shown within the first 6 months after repair. Such a noninvasive technique is therefore regarded as an additional method of study of the structural andfunctional state of the mitral valve after annuloplasty and the subsequent changes in time. The contribution of mitral ring movement to the familiar mitral echogram pattern is discussed passim.

Mitral valve closure index. Echocardiographic index of severity of mitral stenosis.

“…In the assessment of the functional severity of mitral stenosis the echocardiogram has so far made no definite contribution. Several investigators (Edler, 1967;Effert, 1967;Gustafason, 1967) proposed that the diastolic closure rate based on the EF slope of the anterior leaflet of the mitral valve reflects the severity of mitral stenosis but, like others (Mary et al, 1973;Cope et al, 1975), we found it to be insensitive and often misleading in individual patients. We report here a new index of mitral valve closure, derived from the rate at which the anterior and posterior leaflet echoes approximate, which correlates with the severity of the mitral stenosis sufficiently well to be of clinical value.…”

Use of digitised left ventricular echocardiograms in assessment of mitral stenosis.

“…We agree with previous authors (Mary et al, 1973;Cope et al, 1975;Shiu, 1977) that the EF slope of the anterior mitral leaflet echo is an unreliable index of the severity of mitral stenosis. On the other hand, in the present study the rate of change of left ventricular dimension reflected the functional haemodynamic disturbance in mitral stenosis.…”

“…Several investigators (Segal et al, 1966;Edler, 1967;Effert, 1967;Gustafson, 1967) have claimed that the diastolic EF slope of the anterior mitral leaflet reflects the severity of mitral stenosis. As has previously been reported by others (Mary et al, 1973;Cope et al, 1975;Shiu, 1977), we also have frequently noticed discrepancies in patients with mitral stenosis between echocardiographic data and data obtained invasively by cardiac catheterisation and angiography. We have found that the EF slope is not a sensitive measure of the severity of mitral stenosis and is often misleading in individual patients.…”

“…The rate of diastolic descent of the cage and ball is much reduced in the absence of significant obstruction across the prosthesis. If the movement of the anterior mitral leaflet in mitral stenosis is indeed related to movement of the valve ring, it is not surprising that the EF slope has little relation to the mitral valve area (Mary et al, 1973;Cope et al, 1975;Shiu, 1977).…”

Echocardiographic pattern of posterior mitral valve leaflet movement after mitral valve repair.

“…Twelve of the 28 patients had pure or predominant mitral regurgitation and 16 had mixed mitral valve disease. All the patients had open mitral annuloplasty (Wooler et al, 1962), the indications for which have been previously described (Mary et al, 1973). In addition to mitral annuloplasty, one patient required plication of the posterior leaflet and one closure of an atrial septal defect.…”