Value of Systolic Pulmonary Venous Flow Reversal and Color Doppler Jet Measurements Assessed With Transesophageal Echocardiography in Recognizing Severe Pure Mitral Regurgitation
Section snippets
METHODS
The study group consisted of 62 consecutive patients (38 men and 24 women, aged 38 to 80 years, mean 61) with angiographically proven chronic MR, accepted for mitral valve surgery (n = 32), aortic valve surgery (n = 7), or coronary artery bypass surgery (n = 23) during a 10-month period, and who underwent preoperative TEE for (concomitant) mitral valve surgery because of MR. The interval between angiography and echocardiography was <2 months. Informed consent was obtained from all patients and
RESULTS
Cineangiography: Three patients had grade I, 12 grade II, 26 grade III, and 21 grade IV MR. Because distinguishing between mild/moderate and severe MR is of clinical importance, we concentrated our analysis on 2 groups: 15 patients with grade I/II MR and 47 patients with grade III/IV MR.
Pulmonary venous flow pattern: Systolic pulmonary venous flow reversal was not found in grade I patients, in 1 grade II patient (8%), in 21 grade III patients (81%), and in 20 grade IV patients (95%), and was
DISCUSSION
Pulmonary venous flow: The present study underlines the value of flow reversal in identifying patients with severe MR. This is in agreement with previous studies.1, 2, 3, 4 Flow reversal was very capable of distinguishing grade I/II from grade III/IV MR, but not of distinguishing grade III from grade IV MR. This contradicts the results of Klein et al[2] but is in agreement with the study of Lai et al.[4] Neither Klein nor Lai differentiated between pansystolic and late systolic flow reversal.
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