Effect of general anesthesia on the severity of mitral regurgitation by transesophageal echocardiography

The effect of general anesthesia on the severity of mitral regurgitation (M R) was examined in 43 patients with moderate or severe MR who underwent pre operative and intraoperative transesophageal echocardiography, Systolic blo od pressure, mean arterial pressure, and left ventricular end-diastolic and end-systolic dimensions were significantly lower during the intraoperative study, reflecting altered loading conditions. The mean color Doppler jet a rea and mean vena contracta decreased and the mean pulmonary venous flow pa ttern changed from reversed to blunted, reflecting a significant reduction in the severity of MR. Overall, 22 of the 43 patients (51%) improved at lea st 1 MR severity grade when assessed under general anesthesia. Thus, intrao perative transesophageal echocardiography may significantly underestimate t he severity of MR. A thorough preoperative assessment is preferable when de ciding whether to perform mitral valve surgery. (C) 2000 by Excerpta Medica , Inc.