[The usefulness of transesophageal echocardiography during percutaneous balloon mitral valvulotomy]

The purpose of this study is to report the experience at Instituto de Cardiología de México with transesophageal echocardiography during percutaneous mitral valvulotomy and to compare its utility with transthoracic echocardiography. Sixteen patients with isolated or predominant mitral stenosis were examined and underwent percutaneous mitral valvulotomy with a single balloon catheter (Inoue [correction of Ionue] technique). Transthoracic echocardiography was done in all cases previous to the procedure. The procedure orientation was done with transesophageal in thirteen patients and with. Transthoracic echocardiography in the other three. The results were successful in all cases. Transesophageal echocardiography was more useful in the initial evaluation in patients with poor transthoracic windows, in those with clinical and/or transthoracic evidence of atrial thrombosis, as well as in procedure orientation, spontaneous contrast detection, mitral regurgitation and atrial septal defect evaluation after the procedure. Transesophageal echocardiography is superior to transthoracic technique in procedure orientation, early evaluation of results and potential complications. However, its practical utility is limited and its routine use is not recommended.