Why the study?
Does transesophageal echocardiography improve the assessment of left atrial thrombus in patients being considered for percutaneous mitral valvuloplasty compared to standard precordial echocardiography?
Does transesophageal echocardiography improve the assessment of left atrial thrombus in patients being considered for percutaneous mitral valvuloplasty compared to standard precordial echocardiography?
Transesophageal echocardiography is recommended to accurately rule out left atrial thrombus in patients undergoing percutaneous mitral valvuloplasty.
Answers are grounded in this paper and cite their sources.
Supports TEE for clarifying equivocal precordial findings before mitral valvuloplasty; leaves open need for prospective validation.
As percutaneous mitral valvuloplasty gains wider acceptance, appropriate selection of patients for this procedure continues to be important. The presence of atrial thrombus is a contraindication, and transesophageal echocardiography provides optimal visualization of the left atrium and atrial appendage to assess for the presence of thrombus. This case report describes a patient in whom left atrial thrombus was suspected based on standard precordial echocardiography. After transesophageal echocardiography demonstrated the structure in question to be a normal portion of the left atrial wall, the patient underwent successful uncomplicated percutaneous mitral valvuloplasty. We recommend transesophageal echocardiography in all patients being considered for percutaneous valvuloplasty for mitral stenosis.
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Casale et al. (1989) studied this question.
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