Veeramani, S R (2011) Three Dimensional Echocardiography a Novel Technique for Rheumatic Mitral Valve Stenosis Evaluation. Masters thesis, Madurai Medical College, Madurai.
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Abstract
INTRODUCTION : Mitral stenosis is characterized by restriction of blood flow from the left atrium (LA) to the left ventricle (LV) as a result of a narrowed mitral passage. It is an acquired valvular defect; it is usually a consequence of rheumatic heart disease, though cases of congenital mitral stenosis are occasionally encountered. The fundamental treatment for rheumatic mitral stenosis2 is to increase the mitral valve area (MVA) by means of percutaneous transvenous mitral commissurotomy or by surgical valve replacement. In order to establish the time of surgery and an optimal management, it is essential to make an appropriate and accurate assessment of its severity. At present, the invasive measurement of the mitral valve area is based on the Gorlin formula. This method has been used as the invasive reference method to assess the severity of the rheumatic mitral stenosis. However, it is an invasive method that may result in complications and inaccuracies. Recently, 3DFull volume Planimetry has become an available technique in many echocardiography labs, providing numerous advantages in the assessment of valvular disease. AIM OF THE STUDY : Our aim was to assess which echo cardio graphic method has the best agreement with the mitral valve area (MVA) invasively evaluated by the Gorlin's formula. We had to evaluate the feasibility and reproducibility of Three-dimensional echocardiography for the estimation of MVA and the Wilkins score in patients with rheumatic mitral stenosis. CONCLUSION : Trans thoracic 3D echocardiography offered visualization of the entire mitral valve apparatus, and allowed en face views of the mitral funnel orifice, from which accurate measurements of the MVA can be made pre- PTMC. It was also a very suitable technique for monitoring both the efficacy of the PTMC procedure (commissural splitting, MVA before and after), as well as its complications (leaflet tearing and mitral regurgitation) with a better accuracy compared to 2D planimetry and pressure half-time derived-MVA. 3D Full volume Planimetry9 allowed a different and superior evaluation of the mitral valve apparatus, improving the ability to obtain an accurate measurement of the MVA. Hence, Trans thoracic 3D Echocardiography is a feasible and accurate technique for measuring MVA in patients with Rheumatic Mitral Stenosis, in Pre, Intra and Post PTMC states compared to the Pressure half-time method, PISA and 2D echo planimetry.
| Item Type: | Thesis (Masters) |
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| Uncontrolled Keywords: | Three Dimensional ; Echocardiography ; Novel Technique ; Rheumatic ; Mitral Valve ; Stenosis Evaluation. |
| Subjects: | MEDICAL > Cardiology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 06 Jul 2017 05:17 |
| Last Modified: | 06 Jul 2017 10:23 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/1081 |
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