Valvular Heart DiseaseComparison of Vena Contracta Width by Multiplane Transesophageal Echocardiography With Quantitative Doppler Assessment of Mitral Regurgitation
Section snippets
Patient Group:
We prospectively studied 35 patients with MR who were referred for TEE at Parkland Memorial Hospital (n = 24) or the Dallas VA Medical Center (n = 11). Patients were excluded from the study if they had aortic regurgitation or stenosis, significant mitral stenosis, acute myocardial infarction, and a mechanical or bioprosthetic valve. Of the 36 patients who were initially enrolled, only 1 patient was excluded due to inability to measure the mitral or aortic annulus. Patients ranged in age from 23
Transthoracic Echocardiography:
MR jets were eccentric in 19 patients and central in 16 patients. The mean mitral time–velocity integral in 28 of the 35 patients was 130 ± 28 cm (range 76 to 170). The time–velocity integral could not be obtained in 8 patients due to technical difficulty. The mean regurgitant volume was 74 ± 54 ml (range 6 to 189). The mean regurgitant fraction was 0.53 ± 0.20 (range 0.08 to 0.82). The mean effective orifice area in the 28 patients for whom the time–velocity integral was obtained was 0.69 ±
Discussion
Previous studies have reported that vena contracta width may be a useful method to assess the severity of MR. The present study is the first to compare simultaneous measurements of vena contracta width by multiplane TEE with quantitative Doppler measurements of regurgitant volume and effective regurgitant orifice area. Previous investigators have measured vena contracta width and proximal MR jet size by transthoracic echocardiography and reported larger discriminative values to identify severe
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