Transesophageal Echocardiographic Evaluation of Pulmonary Venous Flow before, after and One-year after Percutaneous Mitral Valvulopasty in Patients with Mitral Stenosis in Sinus Rhythm

Abstract

Background:To evaluate the influence of changes in mitral valve area (MVA and left atrial pressure on pulmonary vein flow (PVF we analyzed PVF with transesophageal echocardiography (TEE before, after and one-year after percutaneous mitral valvuloplasty (PMV in patients with mitral stenosis (MS in sinus rhythm. Methods:PMV was guided with TEE. Follow-up TEE was done about one year after PMV. MVA and transmitral mean gradient (TMG were measured. Systolic velocity (S, diastolic velocity (D, atrial reversal velocity (AR, their time-velocity integral (S-TVI, D-TVI, AR-TVI and their ratio (S/D ratio, S-TVI/D-TVI ratio were evaluated. Results:The number of patients was twenty-two (F:20. The age was 39±9 years (range:26-64. Follow-up duration was 16±6 months (range:7-28. MVA increased from 0.9±0.2 cm 2 to 1.9±0.3 cm 2 after PMV and decreased to 1.7±0.3 cm 2 on follow-up TEE significantly. TMG decreased from 15.4±4.3 mmHg to 5.5±1.9 mmHg after PMV and was 6.2±2.4 mmHg on follow-up. S increased significantly on follow-up at both pulmonary vein (PV. D increased on follow-up at left PV. S/D ratio increased on follow-up at both PV. AR increased on follow-up at both PV. S-TVI increased after PMV at left PV and increased on follow-up at both PV. D-TVI had no change. S-TVI/D-TVI ratio increased on follow-up at left PV. AR-TVI increased on follow-up at right PV. Conclusions:The main changes after PMV in patients with MS in sinus rhythm were increasing tendency in S, S-TVI, S/D ratio, S-TVI/D-TVI ratio and AR. And these changes were statistically significant on follow-up TEE rather than immediately after PMV. (Korean Circulation J 2000;30(2 :134-140