PREDICTION OF CHANGE IN MITRAL-VALVE AREA AFTER MITRAL BALLOON COMMISSUROTOMY USING CINE COMPUTED-TOMOGRAPHY

RATIONALE AND OBJECTIVES. Mitral balloon commissurotomy (MBC) can succ essfully increase the mitral valve area (MVA) in mitral stenosis, but the outcome is variable. In multicenter studies, qualitative echocardi ographic scores obtained before MBC are only weakly predictive of the increase in MVA after MBC. METHODS. To evaluate whether the change in MVA after MBC can be predicted by evaluating mitral valve morphology u sing cine computed tomography (CT), we studied 12 women with mitral st enosis and 11 female control subjects. RESULTS. In the patients with m itral stenosis, MVA increased from 1.13 +/- 0.24 to 1.93 +/- 0.56 cm(2 ) (P < .0001) after MBC. A standard echocardiographic score assessment of mitral valve morphology before MBC was not associated with the cha nge in MVA after MBC in these patients (P > .20). However, the total m itral valve morphology score evaluated by cine computed tomography was strongly associated with the change in MVA after MBC (r = -.87; P < . 0005). In addition, the individual morphologic characteristics of mitr al valve mobility (P < .0025), leaflet thickness (P < .05), and subval vular disease (P < .05) were significant predictors of the change in M VA after MBC. CONCLUSION. Cine computed tomography may be useful for p redicting immediate increases in MVA in patients after MBC and may be helpful for preoperative assessment of these patients.