2-DIMENSIONAL TRANSESOPHAGEAL ECHOCARDIOGRAPHIC DETERMINATION OF MITRAL-VALVE AREA IN ADULTS WITH MITRAL-STENOSIS

Two-dimensional transthoracic echocardiography has been shown to be a reliable and accurate method of measuring stenotic mitral valve orific e area. Little data exist on the role of two-dimensional transesophage al echocardiography for this purpose. Thus in 45 adult patients with m itral stenosis mitral valve area was determined by direct planimetry w ith the use of two-dimensional transesophageal and transthoracic echoc ardiography. Transesophageal was less feasible than transthoracic echo cardiography in the 45 patients (69% vs. 89%, p < 0.025). In 14 patien ts, two-dimensional transesophageal echocardiography was not feasible, primarily because of leaflet dropout. In 30 patients, transesophageal and transthoracic echocardiography were feasible, and measurements of mitral valve area by the two techniques correlated well (r = 0.91, SE E = 0.33 cm(2), p < 0.0001). Mean mitral valve orifice area determined by transesophageal echocardiography (1.54 +/- 0.75 cm(2); range 0.56 to 3.49 cm(2)) and by transthoracic echocardiography (1.55 +/- 0.78 cm (2); range 0.62 to 3.68 cm(2)) did not differ (p = NS). The absolute ( 0.24 +/- 0.22 cm(2)) and percent (19% +/- 21%) differences between mit ral valve area determined by transesophageal versus transthoracic echo cardiography were small. These data show that mitral valve area in pat ients with mitral stenosis can be accurately measured by direct planim etry with two-dimensional transesophageal echocardiography. Technical refinements such as lateral-gain-compensation features may improve the feasibility of two-dimensional transesophageal echocardiography for m easurements of mitral stenosis area, and this technique may become an adjunct to transthoracic echocardiography in the assessment of severit y of mitral stenosis.