Transesophageal echocardiography detected severe mitral regurgitation in 71.4% of patients with suspected prosthesis malfunction, compared to 21.4% detected by the transthoracic approach.
Observational (n=14)
Single-blind
Does transesophageal echocardiography improve the assessment of mitral prosthesis malfunction compared to transthoracic echocardiography?
Transesophageal echocardiography is superior to the transthoracic approach for visualizing pathological morphology and accurately grading regurgitation in patients with suspected mitral prosthesis malfunction.
Absolute Event Rate: 71.4% vs 21.4%
To determine the value of transesophageal ultrasound in the assessment of cardiac valve prostheses, 14 patients with clinically suspected mitral prosthesis malfunction were studied by transthoracic and transesophageal two-dimensional imaging as well as by color Doppler flow velocity mapping (color Doppler). Patients underwent left ventricular angiography (n = 13), surgery (n = 11), or both angiography and surgery (n = 10). Nine patients had only mitral valve replacement, four patients had both mitral and aortic valve replacement, and one patient had mitral, aortic, and tricuspid valve replacement. There were 16 biological and four mechanical prostheses. The degree of mitral regurgitation was graded by both transthoracic and transesophageal color Doppler according to the area of the regurgitant jet visualized and was compared with a three-point classification of mitral regurgitation by left ventricular angiography judged by observers blinded to the echocardiographic results. All transesophageal studies were performed without complication and were well tolerated. The pathological morphology of the mitral prosthesis was additionally or more clearly visualized by transesophageal two-dimensional imaging and subsequently proven at surgery in three patients with flail leaflets and one patient with a vegetation compared with images obtained by the transthoracic approach. Valvular regurgitation was graded by the transthoracic approach as absent in four patients, mild in two patients, moderate in five patients, and severe in only three patients. The transesophageal assessment showed absence of mitral regurgitation in two patients, moderate regurgitation in two patients, and severe regurgitation in 10 patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Nellessen et al. (Sat,) conducted a observational in Clinically suspected mitral prosthesis malfunction (n=14). Transesophageal echocardiography and color Doppler vs. Transthoracic echocardiography and color Doppler was evaluated on Detection of severe mitral regurgitation. Transesophageal echocardiography detected severe mitral regurgitation in 71.4% of patients with suspected prosthesis malfunction, compared to 21.4% detected by the transthoracic approach.
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