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Colour doppler valvar and subvalvar flow diameter imaging versus echo score in mitral stenosis: comparison with type of surgery

OBJECTIVE: To compare the value of echo score with that of Doppler subvalvar flow broadening in deciding the type of mitral stenosis surgery. PATIENTS: 30 patients, mean age 47 years, with severe stenosis undergoing surgery were divided into two groups according to type of surgery: open heart commis... Full description

Journal Title: Heart (British Cardiac Society) 1996-05, Vol.75 (5), p.486-491
Main Author: Veyrat, C
Other Authors: Pellerin, D , Sainte Beuve, D , Larrazet, F , Kalmanson, D , Witchitz, S
Format: Electronic Article Electronic Article
Language: English
Subjects:
Quelle: Alma/SFX Local Collection
Publisher: London: BMJ Publishing Group Ltd and British Cardiovascular Society
ID: ISSN: 1355-6037
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title: Colour doppler valvar and subvalvar flow diameter imaging versus echo score in mitral stenosis: comparison with type of surgery
format: Article
creator:
  • Veyrat, C
  • Pellerin, D
  • Sainte Beuve, D
  • Larrazet, F
  • Kalmanson, D
  • Witchitz, S
subjects:
  • Abridged Index Medicus
  • Adolescent
  • Adult
  • Aged
  • Biological and medical sciences
  • Cardiology. Vascular system
  • Echocardiography
  • Echocardiography, Doppler, Color
  • Endocardial and cardiac valvular diseases
  • Female
  • Heart
  • Heart Valve Prosthesis
  • Humans
  • Male
  • Medical sciences
  • Middle Aged
  • Mitral Valve - surgery
  • Mitral Valve Stenosis - diagnostic imaging
  • Mitral Valve Stenosis - surgery
  • Patient Selection
  • Prospective Studies
  • Research Article
ispartof: Heart (British Cardiac Society), 1996-05, Vol.75 (5), p.486-491
description: OBJECTIVE: To compare the value of echo score with that of Doppler subvalvar flow broadening in deciding the type of mitral stenosis surgery. PATIENTS: 30 patients, mean age 47 years, with severe stenosis undergoing surgery were divided into two groups according to type of surgery: open heart commissurotomy (group 1, n = 12), or prosthesis (group 2, n = 18). A control group of 10 patients with prosthesis served as reference, representing mild stenosis without subvalvar connection. METHODS: For echo, the score proposed by Wilkins for cross sectional imaging was used. For Doppler, the flow diameters were measured in cm by an independent examiner from the long axis view in early diastole at two levels: (1) at the level of the stenosis (origin flow diameter), and (2) 1.5 cm downstream from the stenosis in the left ventricle (subvalvar flow diameter) with calculation of a Doppler ratio relating these two measurements, expressed as a percentage of broadening. Diagnostic value was compared for both procedures. RESULTS: There was no significant difference in age, mitral valve areas, or haemodynamics for the two groups. Mean values (SD) were: echo score: group 1, 9.83 (1.26) v group 2, 10.8 (8.1), NS; Doppler ratio %: group 1, 44 (24) v group 2, 12 (21) (P < 0.001); control group: 69 (15). The per cent diagnostic value for an open heart commissurotomy of respective cut off points was: Doppler ratio > 25% (range 71% to 87%); echo score < 10 (range 50% to 75%). CONCLUSIONS: The new Doppler ratio diagnostic value agreed better with surgical management, repair or prosthesis, in this study. Thus, it appears to better reflect the subvalvar involvement and changes in kinetics than the echo score alone. This easy Doppler method might become a routine examination for follow up of patients with open heart commissurotomy, to avoid performing repeated transoesophageal echocardiography.
language: eng
source: Alma/SFX Local Collection
identifier: ISSN: 1355-6037
fulltext: fulltext
issn:
  • 1355-6037
  • 1468-201X
url: Link


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titleColour doppler valvar and subvalvar flow diameter imaging versus echo score in mitral stenosis: comparison with type of surgery
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creatorVeyrat, C ; Pellerin, D ; Sainte Beuve, D ; Larrazet, F ; Kalmanson, D ; Witchitz, S
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descriptionOBJECTIVE: To compare the value of echo score with that of Doppler subvalvar flow broadening in deciding the type of mitral stenosis surgery. PATIENTS: 30 patients, mean age 47 years, with severe stenosis undergoing surgery were divided into two groups according to type of surgery: open heart commissurotomy (group 1, n = 12), or prosthesis (group 2, n = 18). A control group of 10 patients with prosthesis served as reference, representing mild stenosis without subvalvar connection. METHODS: For echo, the score proposed by Wilkins for cross sectional imaging was used. For Doppler, the flow diameters were measured in cm by an independent examiner from the long axis view in early diastole at two levels: (1) at the level of the stenosis (origin flow diameter), and (2) 1.5 cm downstream from the stenosis in the left ventricle (subvalvar flow diameter) with calculation of a Doppler ratio relating these two measurements, expressed as a percentage of broadening. Diagnostic value was compared for both procedures. RESULTS: There was no significant difference in age, mitral valve areas, or haemodynamics for the two groups. Mean values (SD) were: echo score: group 1, 9.83 (1.26) v group 2, 10.8 (8.1), NS; Doppler ratio %: group 1, 44 (24) v group 2, 12 (21) (P < 0.001); control group: 69 (15). The per cent diagnostic value for an open heart commissurotomy of respective cut off points was: Doppler ratio > 25% (range 71% to 87%); echo score < 10 (range 50% to 75%). CONCLUSIONS: The new Doppler ratio diagnostic value agreed better with surgical management, repair or prosthesis, in this study. Thus, it appears to better reflect the subvalvar involvement and changes in kinetics than the echo score alone. This easy Doppler method might become a routine examination for follow up of patients with open heart commissurotomy, to avoid performing repeated transoesophageal echocardiography.
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subjectAbridged Index Medicus ; Adolescent ; Adult ; Aged ; Biological and medical sciences ; Cardiology. Vascular system ; Echocardiography ; Echocardiography, Doppler, Color ; Endocardial and cardiac valvular diseases ; Female ; Heart ; Heart Valve Prosthesis ; Humans ; Male ; Medical sciences ; Middle Aged ; Mitral Valve - surgery ; Mitral Valve Stenosis - diagnostic imaging ; Mitral Valve Stenosis - surgery ; Patient Selection ; Prospective Studies ; Research Article
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descriptionOBJECTIVE: To compare the value of echo score with that of Doppler subvalvar flow broadening in deciding the type of mitral stenosis surgery. PATIENTS: 30 patients, mean age 47 years, with severe stenosis undergoing surgery were divided into two groups according to type of surgery: open heart commissurotomy (group 1, n = 12), or prosthesis (group 2, n = 18). A control group of 10 patients with prosthesis served as reference, representing mild stenosis without subvalvar connection. METHODS: For echo, the score proposed by Wilkins for cross sectional imaging was used. For Doppler, the flow diameters were measured in cm by an independent examiner from the long axis view in early diastole at two levels: (1) at the level of the stenosis (origin flow diameter), and (2) 1.5 cm downstream from the stenosis in the left ventricle (subvalvar flow diameter) with calculation of a Doppler ratio relating these two measurements, expressed as a percentage of broadening. Diagnostic value was compared for both procedures. RESULTS: There was no significant difference in age, mitral valve areas, or haemodynamics for the two groups. Mean values (SD) were: echo score: group 1, 9.83 (1.26) v group 2, 10.8 (8.1), NS; Doppler ratio %: group 1, 44 (24) v group 2, 12 (21) (P < 0.001); control group: 69 (15). The per cent diagnostic value for an open heart commissurotomy of respective cut off points was: Doppler ratio > 25% (range 71% to 87%); echo score < 10 (range 50% to 75%). CONCLUSIONS: The new Doppler ratio diagnostic value agreed better with surgical management, repair or prosthesis, in this study. Thus, it appears to better reflect the subvalvar involvement and changes in kinetics than the echo score alone. This easy Doppler method might become a routine examination for follow up of patients with open heart commissurotomy, to avoid performing repeated transoesophageal echocardiography.
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19Patient Selection
20Prospective Studies
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titleColour doppler valvar and subvalvar flow diameter imaging versus echo score in mitral stenosis: comparison with type of surgery
authorVeyrat, C ; Pellerin, D ; Sainte Beuve, D ; Larrazet, F ; Kalmanson, D ; Witchitz, S
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abstractOBJECTIVE: To compare the value of echo score with that of Doppler subvalvar flow broadening in deciding the type of mitral stenosis surgery. PATIENTS: 30 patients, mean age 47 years, with severe stenosis undergoing surgery were divided into two groups according to type of surgery: open heart commissurotomy (group 1, n = 12), or prosthesis (group 2, n = 18). A control group of 10 patients with prosthesis served as reference, representing mild stenosis without subvalvar connection. METHODS: For echo, the score proposed by Wilkins for cross sectional imaging was used. For Doppler, the flow diameters were measured in cm by an independent examiner from the long axis view in early diastole at two levels: (1) at the level of the stenosis (origin flow diameter), and (2) 1.5 cm downstream from the stenosis in the left ventricle (subvalvar flow diameter) with calculation of a Doppler ratio relating these two measurements, expressed as a percentage of broadening. Diagnostic value was compared for both procedures. RESULTS: There was no significant difference in age, mitral valve areas, or haemodynamics for the two groups. Mean values (SD) were: echo score: group 1, 9.83 (1.26) v group 2, 10.8 (8.1), NS; Doppler ratio %: group 1, 44 (24) v group 2, 12 (21) (P < 0.001); control group: 69 (15). The per cent diagnostic value for an open heart commissurotomy of respective cut off points was: Doppler ratio > 25% (range 71% to 87%); echo score < 10 (range 50% to 75%). CONCLUSIONS: The new Doppler ratio diagnostic value agreed better with surgical management, repair or prosthesis, in this study. Thus, it appears to better reflect the subvalvar involvement and changes in kinetics than the echo score alone. This easy Doppler method might become a routine examination for follow up of patients with open heart commissurotomy, to avoid performing repeated transoesophageal echocardiography.
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pmid8665342
doi10.1136/hrt.75.5.486
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