Quantification of rheumatic mitral stenosis severity with three dimensional vena contracta area

Abstract

Rheumatic mitral stenosis is a real public health problem in developing countries. Assessment of the mitral valve area (MVA) is essential for the choice of the intervention time. Most of the evaluation parameters of rheumatic MS are derived of two-dimensional echocardiography (2D). Three-dimensional transthoracic echocardiography (3D) is commonly used in our daily practice today. The purpose of this study was to evaluate the value of the vena contracta area (VCA) to predict the severity of rheumatic MS by comparing 3D planimetry. Patients who were diagnosed with severe rheumatic MS with conventional methods (half-pressure, planimetry) by 2D transthoracic echocardiography (TTE), underwent 3D TTE assessment. The VCA of the mitral valve was measured at maximum opening, with measurement planimetry MVA by metre/cropping TTE 3D. We studied 92 patients (mean age: 42 years) with Rheumatic MS. 15% (14 cases) had a 3D mitral area smaller than the mitral area per vena contracta, 80% (73 cases) the mitral area per vena contracta was smaller than 3D and 5% (5 cas) SP was equal in the two methods. The results of our study provide evidence that the VCA of the 3D TTE mitral valve can be used routinely to detect the severity of mitral stenosis.