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[Transesophageal echocardiography study of mitral valve prosthesis]
J E Azevedo1, M A Garcia-Fernandez, D San Roman
1Laboratório de Ecocardiografia, Hospital General Gregorio Maranon, Madrid.
Objective:
Transesophageal (TEE) and Transthoracic (TTE) comparative echocardiographic analysis of patients with mitral valve prosthesis.
Design:
Prospective study.
Setting:
In hospital and out patients with mitral prosthesis in a follow-up study by the Cardiology Department and referred to the echocardiographic laboratory of Gregorio Marañon General Hospital, Madrid.
Patients:
We studied 90 consecutive patients with mitral prosthesis diagnosis.
Interventions:
Comparative and prospective echocardiographic study of transthoracic and transesophageal techniques in mitral prosthesis pathology.
Results:
TTE diagnosed 18% of dysfunctioning mitral prosthesis patients compared to 56% of cases identified by TEE. TTE observed 1% of mitral prosthesis vegetation compared to 8.8% by TEE. TEE diagnosed left atrial thrombosis in 2.2% and TEE in 10%. Left atrial spontaneous dynamic contrast was identified exclusively by TEE in 55% of all cases. Paravalvular mitral prosthesis leak was correctly identified exclusively by TEE in 20% of cases.
Conclusions:
TEE has a greater diagnostic capacity compared to TTE in mitral prosthesis patients. This technique can give a greater security in evaluating mitral prosthesis thrombi, vegetations and leak, establishing a more precise diagnosis of mitral prosthesis dysfunction. The authors concluded that TEE is the technique of choice in noninvasive evaluation of patients admitted with the suspicion of mitral prosthesis dysfunction.