Usefulness of intraoperative transesophageal echocardiography in predicting the degree of mitral regurgitation secondary to atrioventricular defect in children

The objectives of this study were to determine the validity of the grade of mitral regurgitation (MR) as imaged by intraoperative transesophageal echo cardiography (TEE) in predicting the grade of MR at follow-up. Intraoperati ve TEE and corresponding follow-up transthoracic studies were retrospective ly reviewed and the regurgitant jet area to left atrial area ratio was used to quantify the MR, Patient records were reviewed to identify factors cont ributing to the development of a certain grade of MR. Intraoperative TEE wa s useful in detecting severe MR that required further repair at the same ti me. However, discrepancy in the grade of MR at follow-up was noted in 47% o f patients (21 of 47) and unchanged grade of MR was found only in 53% of pa tients (26 of 47), Blood pressures were significantly lower and heart rates higher intraoperatively, Initial preoperative grade of MR and type of atri oventricular canal defect did not predispose fdr a particular grade of MR a t follow-up. The grade of MR by intraoperative TEE does not predict the gra de of MR at follow-up as imaged by transthoracic echocardiography. (C)1999 by Excerpta Medica, Inc.