RT Journal Article SR Electronic T1 Assessment of severity of mechanical prosthetic mitral regurgitation by transoesophageal echocardiography JF Heart JO Heart FD BMJ Publishing Group Ltd and British Cardiovascular Society SP 539 OP 544 DO 10.1136/hrt.2003.026823 VO 90 IS 5 A1 A Vitarelli A1 Y Conde A1 E Cimino A1 T Leone A1 I D’Angeli A1 S D’Orazio A1 S Stellato YR 2004 UL http://heart.bmj.com/content/90/5/539.abstract AB Objective: To evaluate the ability of colour Doppler transoesophageal echocardiography (TOE) to assess quantitatively prosthetic mitral valve insufficiency. Methods: 47 patients were studied with multiplane TOE and cardiac catheterisation. Proximal jet diameter was measured as the largest diameter of the vena contracta. Regurgitant area was measured by planimetry of the largest turbulent jet during systole. Flow convergence zone was considered to be present when a localised area of increased systolic velocities was apparent on the left ventricular side of the valve prosthesis. Pulmonary vein flow velocity was measured at peak systole and diastole. Results: Mean (SD) proximal jet diameter was 0.63 (0.16) cm, with good correlation with angiographic grades (r  =  0.83). Mean (SD) maximum colour jet area was 7.9 (2.5) cm2 (r  =  0.69) with worse correlation if a single imaging plane was used for measurements (r  =  0.62). The ratio of systolic to diastolic peak pulmonary flow velocity averaged 0.7 (1.3) cm (r  =  −0.66) with better correlation (r  =  −0.71) if patients with atrial fibrillation were excluded. Mean (SD) regurgitant flow rate was 168 (135) ml/s and regurgitant orifice area was 0.56 (0.43) cm2, with good correlation with angiography (r  =  0.77 and r  =  0.78, respectively). Conclusions: TOE correctly identified angiographically severe prosthetic mitral regurgitation, mainly by the assessment of the flow convergence region and the proximal diameter of the regurgitant jet.