ECHOCARDIOGRAPHY IN PERCUTANEOUS BALLOON MITRAL VALVULOPLASTY

Percutaneous balloon. valvuloplasty (BV) has been used successfully in recent years for the relief of mitral stenosis, and in many instances , as an alternative to cardiac surgery. This procedure requires precis e evaluation of both value morphology and function for preprocedure de cision making and follow-up of patients. Two-dimensional (2-D) echocar diography is a unique, noninvasive tool for evaluating morphologic cha racteristics of value, subvalvular apparatus, and valve annular size. Doppler echocardiogarphy provides functional information on transvalvu lar flow velocity, which can be used to derive pressure gradient acros s valve and regurgitant flow. Mitral valve area can be either obtained from 2-D echocardiography or derived from Doppler pressure half time. Echocardiography is currently the most widely used technique for asse ssing results of percutaneous BV. More recently, transesophageal echoc ardiography (TEE) has been used for the evaluation of patients undergo ing percutaneous mitral BV in whom left atrial thrombus is suspected a nd for the intraoperative monitoring of the valvuloplasty procedure. I n this article we discuss the advantages and limitations of both trans thoracic echocardiography and TEE, its recent developments in monitori ng the procedure, evaluation of immediate results and long term follow -up after the valvuloplasty procedure, and its clinical utility in, th e selection of patients for percutaneous BV.